Individual provider Active NPI

Emily Krupp Zeisler, D.D.S.

  • General Practice Dentistry
  • Mentor, OH
National Provider Identifier
1205066040
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.023051 Issued in OH
Practice address
8435 Station St
Mentor, OH 44060-4924
Phone
(440) 225-3111
NPI assigned
Jul 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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 30.023051 OH Primary

Addresses

Primary practice location

8435 Station St
Mentor, OH 44060-4924

Mailing address

1493 Arthur Ave
Apt/Suite
Lakewood, OH 44107-3801
Phone (614) 746-1343

Other identifiers 1

IdentifierTypeStateIssuer
2967268MedicaidOH

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
30.023051OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422576000000",
    "number": "1205066040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1493 ARTHUR AVE",
            "address_2": "APT/SUITE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441073801",
            "telephone_number": "614-746-1343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8435 STATION ST",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604924",
            "telephone_number": "440-225-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEISLER",
        "first_name": "EMILY",
        "middle_name": "KRUPP",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2015-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.023051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2967268",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; 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.