Active NPI
Amelia Elizabeth Dubaniewicz, D.D.S.
- Dentist
- Pepper Pike, OH
National Provider Identifier
1235385196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 16819
- Practice address
- 30539 Pinetree Road
Suite 234
Pepper Pike, OH 44124 - Phone
- (216) 464-7979
- NPI assigned
- Aug 12, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 16819 | OH | Primary |
Addresses
Primary practice location
30539 Pinetree Road
Suite 234
Pepper Pike, OH 44124
Mailing address
30539 Pinetree Road
Suite 234
Pepper Pike, OH 44124
Phone (216) 464-7979
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16819 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218499200000",
"number": "1235385196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30539 PINETREE ROAD",
"address_2": "SUITE 234",
"city": "PEPPER PIKE",
"state": "OH",
"postal_code": "44124",
"telephone_number": "216-464-7979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30539 PINETREE ROAD",
"address_2": "SUITE 234",
"city": "PEPPER PIKE",
"state": "OH",
"postal_code": "44124",
"telephone_number": "216-464-7979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUBANIEWICZ",
"first_name": "AMELIA",
"middle_name": "ELIZABETH",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-12",
"last_updated": "2008-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "16819",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pepper Pike, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.