NPIMap

Organization Active NPI

Mark J Kolosionek DDS & Cara L Fawcett DDS Inc

  • Dentist
  • Hudson, OH
National Provider Identifier
1194891911
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18058 Issued in OH
Legal business name
MARK J KOLOSIONEK DDS & CARA L FAWCETT DDS INC
Practice address
45 Milford Road
Suite 17
Hudson, OH 44236
Phone
(330) 650-4558
Fax
(330) 650-6466
NPI assigned
Nov 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mark Joseph Kolosionek, DDSNPI 1346436631
Title
President
Phone
(330) 650-4558

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 18142 OH
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 18058 OH Primary

Addresses

Primary practice location

45 Milford Road
Suite 17
Hudson, OH 44236

Mailing address

45 Milford Road
Suite 17
Hudson, OH 44236
Phone (330) 650-4558

National Provider Directory

National Provider Directory

Locations

45 Milford Dr
Ste 17
Hudson, OH 44236
Phone (330) 650-4558

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194891911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 MILFORD ROAD",
            "address_2": "SUITE 17",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "44236",
            "telephone_number": "330-650-4558",
            "fax_number": "330-650-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MILFORD ROAD",
            "address_2": "SUITE 17",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "44236",
            "telephone_number": "330-650-4558",
            "fax_number": "330-650-6466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK J KOLOSIONEK DDS & CARA L FAWCETT DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOLOSIONEK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-650-4558",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "18142",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "18058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.