Charles P Fenell DDS Ms Inc

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

14662 Issued in OH

Legal business name

CHARLES P FENELL DDS MS INC

Practice address

4568 Mayfield Rd
Suite #203
South Euclid, OH 44121-4064

Phone

(216) 291-9473

Fax

(216) 691-4110

NPI assigned

Feb 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Charles P Fenell, DDS, MS

Title

Owner

Phone

(216) 291-9473

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205974078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4568 MAYFIELD RD",
            "address_2": "SUITE #203",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441214064",
            "telephone_number": "216-291-9473",
            "fax_number": "216-691-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4568 MAYFIELD RD",
            "address_2": "SUITE #203",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441214064",
            "telephone_number": "216-291-9473",
            "fax_number": "216-691-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES P FENELL DDS MS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FENELL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-291-9473",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OH",
            "license": "14662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in South Euclid, OH by specialty
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• 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.