NPIMap

Individual provider Active NPI

Jay C Resnick, DDS

  • General Practice Dentistry
  • Lyndhurst, OH
National Provider Identifier
1164734869
Registry record updated Jul 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
014141 Issued in OH
Practice address
29001 Cedar Rd
Suite 660
Lyndhurst, OH 44124-4062
Phone
(440) 461-8200
Fax
(440) 461-8343
NPI assigned
Jul 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 014141 OH Primary

Addresses

Primary practice location

29001 Cedar Rd
Suite 660
Lyndhurst, OH 44124-4062

Mailing address

29001 Cedar Rd
Suite 660
Lyndhurst, OH 44124-4062
Phone (440) 461-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
014141OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Streem Resnick Tetelman & Young DDS Inc Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278720000000",
    "number": "1164734869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29001 CEDAR RD",
            "address_2": "SUITE 660",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441244062",
            "telephone_number": "440-461-8200",
            "fax_number": "440-461-8343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29001 CEDAR RD",
            "address_2": "SUITE 660",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441244062",
            "telephone_number": "440-461-8200",
            "fax_number": "440-461-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESNICK",
        "first_name": "JAY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-10",
        "last_updated": "2010-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "014141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyndhurst, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2010; 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.