Individual provider Active NPI

Anthony D Adamo, D.D.S.

  • General Practice Dentistry
  • Westlake, OH
National Provider Identifier
1205987336
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-017291 Issued in OH
Practice address
24700 Center Ridge Rd.
316
Westlake, OH 44145
Phone
(440) 835-3331
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 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 30-017291 OH Primary

Addresses

Primary practice location

24700 Center Ridge Rd.
316
Westlake, OH 44145

Mailing address

24700 Center Ridge Rd
316
Westlake, OH 44145-5636
Phone (440) 835-3331

Other identifiers 3

IdentifierTypeStateIssuer
000447MedicaidOH
34550OtherOHCARE SOURCE
0638519MedicaidOH

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
30-017291OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1205987336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24700 CENTER RIDGE RD",
            "address_2": "316",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455636",
            "telephone_number": "440-835-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24700 CENTER RIDGE RD.",
            "address_2": "316",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "44145",
            "telephone_number": "440-835-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMO",
        "first_name": "ANTHONY",
        "middle_name": "D",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-017291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000447",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE SOURCE",
            "identifier": "34550",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0638519",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.