Omar Alejandro Panol, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

27374 Issued in FL

Practice address

30 Acme St
Marietta, OH 45750-3306

Phone

(740) 373-3136

NPI assigned

May 5, 2020

Last updated

Jul 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Networks

• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Tree Dental D Austin Rehl DDS and Peter E Lovejoy DDS LLC

  dba Family Tree Dental Outreach

  • General Practice Dentistry
  • Marietta, OH
  • NPI 1124429212
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1144841701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14037 NW 88TH PL",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330187343",
            "telephone_number": "305-900-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ACME ST",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457503306",
            "telephone_number": "740-373-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANOL",
        "first_name": "OMAR",
        "middle_name": "ALEJANDRO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-05",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "27374",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael Leanne Pahl, PTA
• Alexis Palazzo, M.S., OTR/L
• Mallory Palmer, CRNA
• Sarah Palmer, DDS
• Hanzara Panol, DMD
• Alyssa K Parker
• Lucas Parks, CDCA
• Shawndra Lea Parks I, RPHD
• Jennifer Elaine Parsons
• Jessica Parsons

• General Practice Dentistry in Marietta, OH
• Providers in Marietta, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.