NPIMap

Organization Active NPI

DRS Pero & Glinka LLC

  • Pediatric Dentistry
  • Maumee, OH
National Provider Identifier
1215010368
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
13806 Issued in OH
Legal business name
DRS PERO & GLINKA LLC
Practice address
5635 Monclova
Maumee, OH 43537-1876
Phone
(419) 893-0708
Fax
(419) 893-2860
NPI assigned
Oct 23, 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. Stephen J Pero, DDSNPI 1710109749
Title
Owner
Phone
(419) 893-0708

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
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 13806 OH Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 14081 OH

Addresses

Primary practice location

5635 Monclova
Maumee, OH 43537-1876

Mailing address

5635 Monclova
Maumee, OH 43537-1876
Phone (419) 893-0708

Other identifiers 1

IdentifierTypeStateIssuer
0304325MedicaidOH

National Provider Directory

National Provider Directory

Locations

5635 Monclova Rd
Maumee, OH 43537
Phone (419) 893-0708

Practitioners & affiliated clinicians

Practitioners 3

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": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215010368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5635 MONCLOVA",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371876",
            "telephone_number": "419-893-0708",
            "fax_number": "419-893-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5635 MONCLOVA",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371876",
            "telephone_number": "419-893-0708",
            "fax_number": "419-893-2860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS PERO & GLINKA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PERO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-893-0708",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "13806",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "14081",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0304325",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, 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.