Carl August Novak, DDS
Individual provider Active NPI Dentist · Clarington, OH
NPI 1124170782 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124170782
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 13949 (OH)
- Practice address
- 139 Monroe Drive
Clarington, OH 43915-0318 - Phone
- (740) 458-1391
- Fax
- (740) 458-1178
- NPI assigned
- Jan 16, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160122002318 | OH | Order and Referring Only - Dentist |
4587967666 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 13949 | OH | Yes |
Addresses
Primary practice location
139 Monroe Drive
Clarington, OH 43915-0318
Mailing address
139 Monroe Drive
PO Box 318
Clarington, OH 43915-0318
Phone (740) 458-1391
Other providers in Clarington, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.