Individual provider Active NPI

Barry A Sogoloff, DMD MS

  • Periodontics
  • Beachwood, OH
National Provider Identifier
1235201823
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
14213 Issued in OH
Practice address
23250 Chagrin Boulevard
Commerce Park Square Building 5 Suite 205
Beachwood, OH 44122
Phone
(216) 292-6787
Fax
(216) 765-1772
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

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
Periodontics 1223P0300X 14213 OH Primary

Addresses

Primary practice location

23250 Chagrin Boulevard
Commerce Park Square Building 5 Suite 205
Beachwood, OH 44122

Mailing address

23250 Chagrin Boulevard
Commerce Park Square Building 5 Suite 205
Beachwood, OH 44122
Phone (216) 292-6787

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
I20150611002715 OH Order and Referring Only - DentistPractitioner - Dentist 8426379793

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
14213OHMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Schwartz, DMD, MD, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235201823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23250 CHAGRIN BOULEVARD",
            "address_2": "COMMERCE PARK SQUARE BUILDING 5 SUITE 205",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "44122",
            "telephone_number": "216-292-6787",
            "fax_number": "216-765-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23250 CHAGRIN BOULEVARD",
            "address_2": "COMMERCE PARK SQUARE BUILDING 5 SUITE 205",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "44122",
            "telephone_number": "216-292-6787",
            "fax_number": "216-765-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOGOLOFF",
        "first_name": "BARRY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "14213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.