NPIMap

Organization Active NPI

Jerome S Kustin D.D.S.

  • Dentist
  • Parma, OH
National Provider Identifier
1265414536
Registry record updated Nov 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12902 Issued in OH
Legal business name
JEROME S KUSTIN D.D.S.
Practice address
5455 Broadview Rd.
#100
Parma, OH 44134
Phone
(216) 741-4600
Fax
(216) 749-0960
NPI assigned
Nov 14, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2010

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

Authorized official

Name
Dr. Jerome S Kustin, DDS
Title
Dentist/Owner
Phone
(216) 741-4600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 12902 OH Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 12902 OH

Addresses

Primary practice location

5455 Broadview Rd.
#100
Parma, OH 44134

Mailing address

5455 Broadview Rd.
#100
Parma, OH 44134
Phone (216) 741-4600

National Provider Directory

National Provider Directory

Locations

5455 Broadview Rd
#100
Parma, OH 44134
Phone (216) 741-4600

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290988800000",
    "number": "1265414536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 BROADVIEW RD.",
            "address_2": "#100",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "44134",
            "telephone_number": "216-741-4600",
            "fax_number": "216-749-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 BROADVIEW RD.",
            "address_2": "#100",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "44134",
            "telephone_number": "216-741-4600",
            "fax_number": "216-749-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEROME S KUSTIN D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-14",
        "last_updated": "2010-11-29",
        "status": "A",
        "authorized_official_last_name": "KUSTIN",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "216-741-4600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "12902",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "12902",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parma, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; 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.