Active NPI
Jeremy Michael Kasik, DMD
- Dentist
- Cleveland, OH
National Provider Identifier
1255063913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 004532
- Practice address
- 4071 Lee Rd Ste 260
Cleveland, OH 44128-2173 - Phone
- (216) 861-6200
- NPI assigned
- Jun 29, 2022
- Sex
- Male
- Sole proprietor
- No
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 | 004532 | OH | Primary |
Addresses
Primary practice location
4071 Lee Rd Ste 260
Cleveland, OH 44128-2173
Mailing address
99 W Saint Clair Ave Apt 1309
Cleveland, OH 44113-1535
Phone (810) 858-9155
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 |
|---|---|---|---|
| 004532 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656460800000",
"number": "1255063913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 W SAINT CLAIR AVE APT 1309",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441131535",
"telephone_number": "810-858-9155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4071 LEE RD STE 260",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441282173",
"telephone_number": "216-861-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASIK",
"first_name": "JEREMY",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-29",
"last_updated": "2022-06-29",
"certification_date": "2022-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "004532",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.