Individual provider Active NPI

Jonathan D Augustine, D.D.S.

  • Dentist
  • Toledo, OH
National Provider Identifier
1265728463
Registry record updated Jun 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30-023465 Issued in OH
Practice address
2138 Madison Ave
Toledo, OH 43604-5131
Phone
(419) 241-1644
NPI assigned
Jun 26, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30-023465 OH Primary

Addresses

Primary practice location

2138 Madison Ave
Toledo, OH 43604-5131

Mailing address

2138 Madison Ave
Toledo, OH 43604-5131
Phone (419) 241-1644

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
I20160506000779 OH Order and Referring Only - DentistPractitioner - Dentist 2466751847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30-023465OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Excellence of Napoleon, LLC, Michael Carpenter, D.D.S. PastSince Oct 13, 2014 Accepting new patients

Organizations & group practices 1

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": "1309046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309046400000",
    "number": "1265728463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2138 MADISON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436045131",
            "telephone_number": "419-241-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2138 MADISON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436045131",
            "telephone_number": "419-241-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUGUSTINE",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-26",
        "last_updated": "2011-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-023465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.