Active NPI
David Mark Raiffe, DDS
- Dentist
- Akron, OH
National Provider Identifier
1174829287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019625
- Practice address
- 916 Kenmore Blvd
Akron, OH 44314-2113 - Phone
- (330) 753-8155
- NPI assigned
- Feb 7, 2011
- Last updated
- Dec 22, 2017
- 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 | 019625 | OH | Primary |
Addresses
Primary practice location
916 Kenmore Blvd
Akron, OH 44314-2113
Mailing address
1019 N Park Ave
Warren, OH 44483-3725
Phone (330) 395-3820
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0963631 | Medicaid | OH |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019625 | OH | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Warren Dental Group, David M Raiffe, DDS, Mba, Inc | General Practice | Past | Accepting new patients |
| Alan B Schlesinger DDS LLC | General Practice | Past | Accepting new patients |
| Alan B Schlesinger DDS LLC | Dentist | Past | Accepting new patients |
| David M. Raiffe DDS Mba | General Practice | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- General Practice Dentistry
- Warren, OH
- NPI 1013250026
-
dba Kenmore Family Dental
- General Practice Dentistry
- Canton, OH
- NPI 1255785887
-
dba Warren Dental Group Alan B Schlesinger DDS LLC
- Dentist
- Warren, OH
- NPI 1558860130
-
dba Kenmore Family Dental
- General Practice Dentistry
- Akron, OH
- NPI 1811273238
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513900800000",
"number": "1174829287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1019 N PARK AVE",
"city": "WARREN",
"state": "OH",
"postal_code": "444833725",
"telephone_number": "330-395-3820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "916 KENMORE BLVD",
"city": "AKRON",
"state": "OH",
"postal_code": "443142113",
"telephone_number": "330-753-8155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAIFFE",
"first_name": "DAVID",
"middle_name": "MARK",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-07",
"last_updated": "2017-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "019625",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0963631",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Akron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.