Charles A Babbush, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30012831 Issued in OH

Practice address

31099 Chagrin Blvd
Suite 100
Pepper Pike, OH 44124

Phone

(216) 450-5888

Fax

(216) 450-5505

NPI assigned

Jul 7, 2005

Last updated

Feb 19, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235001600000",
    "number": "1285632976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31099 CHAGRIN BLVD",
            "address_2": "SUITE 100",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "44124",
            "telephone_number": "216-450-5888",
            "fax_number": "216-450-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31099 CHAGRIN BLVD",
            "address_2": "SUITE 100",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "44124",
            "telephone_number": "216-450-5888",
            "fax_number": "216-450-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABBUSH",
        "first_name": "CHARLES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2009-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30012831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Pepper Pike, OH
• Providers in Pepper Pike, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; 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.