NPIMap

Organization Active NPI

Brian L. Kresevic, DDS, LLC

  • General Practice Dentistry
  • Geneva, OH
National Provider Identifier
1235313339
Registry record updated Dec 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19986 Issued in OH
Legal business name
BRIAN L. KRESEVIC, DDS, LLC
Practice address
184 S Broadway
Geneva, OH 44041-1805
Phone
(440) 466-4884
Fax
(440) 466-0636
NPI assigned
Dec 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2007

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

Authorized official

Name
Dr. Brian Ludwig Kresevic, DDSNPI 1568596815
Title
President
Phone
(440) 466-4884

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
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 19986 OH Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 20027 OH

Addresses

Primary practice location

184 S Broadway
Geneva, OH 44041-1805

Mailing address

184 S Broadway
Geneva, OH 44041-1805
Phone (440) 466-4884

National Provider Directory

National Provider Directory

Locations

184 S Broadway
Geneva, OH 44041
Phone (440) 466-4884

Practitioners & affiliated clinicians

Practitioners 2

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": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198627200000",
    "number": "1235313339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 S BROADWAY",
            "city": "GENEVA",
            "state": "OH",
            "postal_code": "440411805",
            "telephone_number": "440-466-4884",
            "fax_number": "440-466-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 S BROADWAY",
            "city": "GENEVA",
            "state": "OH",
            "postal_code": "440411805",
            "telephone_number": "440-466-4884",
            "fax_number": "440-466-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN L. KRESEVIC, DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2007-12-26",
        "status": "A",
        "authorized_official_last_name": "KRESEVIC",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "LUDWIG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-466-4884",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "19986",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "20027",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; 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.