Individual provider Active NPI

Pierre Duncan, DMD

  • Dentist
  • Ravenna, OH
National Provider Identifier
1245806033
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.026531 Issued in OH
Practice address
250 S Chestnut St Ste 30
Ravenna, OH 44266-3031
Phone
(216) 860-0120
NPI assigned
Jun 2, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.026531 OH Primary

Addresses

Primary practice location

250 S Chestnut St Ste 30
Ravenna, OH 44266-3031

Mailing address

4163 Pearl Rd
Cleveland, OH 44109-3332

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
I20211013002707 OH Order and Referring Only - DentistPractitioner - Dentist 7911305479

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": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1245806033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4163 PEARL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441093332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S CHESTNUT ST STE 30",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663031",
            "telephone_number": "216-860-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "PIERRE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.026531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ravenna, OH

Sources for this page

Verify at the official NPI Registry.