Individual provider Active NPI

Richard John Bobulsky, DDS, MSD

  • Periodontics
  • Parma Heights, OH
National Provider Identifier
1285689570
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
17306 Issued in OH
Practice address
7057 W 130TH St
Suite 203
Parma Heights, OH 44130-7841
Phone
(440) 885-4200
Fax
(440) 885-0082
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 17306 OH Primary

Addresses

Primary practice location

7057 W 130TH St
Suite 203
Parma Heights, OH 44130-7841

Mailing address

7057 W 130TH St
Suite 203
Parma Heights, OH 44130-7841
Phone (440) 885-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17306OHMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1285689570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7057 W 130TH ST",
            "address_2": "SUITE 203",
            "city": "PARMA HEIGHTS",
            "state": "OH",
            "postal_code": "441307841",
            "telephone_number": "440-885-4200",
            "fax_number": "440-885-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7057 W 130TH ST",
            "address_2": "SUITE 203",
            "city": "PARMA HEIGHTS",
            "state": "OH",
            "postal_code": "441307841",
            "telephone_number": "440-885-4200",
            "fax_number": "440-885-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBULSKY",
        "first_name": "RICHARD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "17306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parma Heights, OH

Sources for this page

Verify at the official NPI Registry.