Individual provider Active NPI

Martin Carl Raupple, DDS

  • General Practice Dentistry
  • Canfield, OH
National Provider Identifier
1225161789
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14632 Issued in OH
Practice address
6715 Tippecanoe Rd Ste E102
Canfield, OH 44406-9183
Phone
(330) 702-9000
Fax
(330) 702-9033
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 14632 OH Primary

Addresses

Primary practice location

6715 Tippecanoe Rd Ste E102
Canfield, OH 44406-9183

Mailing address

6715 Tippecanoe Rd Ste E102
Canfield, OH 44406-9183
Phone (330) 702-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161208001650 OH Order and Referring Only - DentistPractitioner - Dentist 6800176884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225161789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6715 TIPPECANOE RD STE E102",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069183",
            "telephone_number": "330-702-9000",
            "fax_number": "330-702-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6715 TIPPECANOE RD STE E102",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069183",
            "telephone_number": "330-702-9000",
            "fax_number": "330-702-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUPPLE",
        "first_name": "MARTIN",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "14632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canfield, OH

Sources for this page

Verify at the official NPI Registry.