Individual provider Active NPI

Matthew Jon Lemke, D.D.S.

  • Periodontics
  • Independence, OH
National Provider Identifier
1265720767
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
30.023449 Issued in OH
Practice address
6505 Rockside Rd Ste 310
Independence, OH 44131-2386
Phone
(216) 642-9111
NPI assigned
Jul 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 30.023449 OH Primary

Addresses

Primary practice location

6505 Rockside Rd Ste 310
Independence, OH 44131-2386

Mailing address

20187 Ellsworth Dr
Strongsville, OH 44149-6795

Other practice location 1

750 E Washington St Ste B2
Medina, OH 44256-2137
Phone (330) 725-6151

Other practice location 2

1706 Wooster
Wooster, OH 44691
Phone (330) 264-5851

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

LicenseStateTypeSpecialty
30.023449OHMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Morgan & Lemke DDS Ms Inc Periodontics CurrentSince Mar 24, 2024 Accepting new patients
Dr. John Solooki & Associates (Fairlawn), Inc. General Practice Past Accepting new patients

Locations

6505 Rockside Rd
Ste 310
Independence, OH 44131
Phone (216) 642-9111

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1265720767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20187 ELLSWORTH DR",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441496795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 ROCKSIDE RD STE 310",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312386",
            "telephone_number": "216-642-9111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 E Washington St Ste B2",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "OH",
            "postal_code": "442562137",
            "country_code": "US",
            "telephone_number": "330-725-6151",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1706 Wooster",
            "address_purpose": "LOCATION",
            "city": "Wooster",
            "state": "OH",
            "postal_code": "44691",
            "country_code": "US",
            "telephone_number": "330-264-5851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEMKE",
        "first_name": "MATTHEW",
        "middle_name": "JON",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-18",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "30.023449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.