Active NPI
Daniel Robert Pugsley I, DDS
- Dentist
- Beachwood, OH
National Provider Identifier
1174772347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 16475
- Practice address
- 24300 Chagrin Blvd
Beachwood, OH 44122-5639 - Phone
- (216) 464-7820
- NPI assigned
- Sep 12, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 16475 | OH | Primary |
Addresses
Primary practice location
24300 Chagrin Blvd
Beachwood, OH 44122-5639
Mailing address
24300 Chagrin Blvd
Beachwood, OH 44122
Phone (216) 464-7820
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16475 | Other | OH | STATE DENTAL LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16475 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221177600000",
"number": "1174772347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24300 CHAGRIN BLVD",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "44122",
"telephone_number": "216-464-7820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24300 CHAGRIN BLVD",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441225639",
"telephone_number": "216-464-7820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUGSLEY",
"first_name": "DANIEL",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"name_suffix": "I",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-12",
"last_updated": "2008-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "16475",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE DENTAL LICENSE",
"identifier": "16475",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beachwood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.