NPIMap

Individual provider Active NPI

Agnish Mahesh Gholekar, DDS

  • General Practice Dentistry
  • Norwalk, OH
National Provider Identifier
1295387983
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.026675 Issued in OH
Practice address
265 Benedict Ave
Norwalk, OH 44857-2346
Phone
(419) 502-2800
Fax
(419) 502-2821
NPI assigned
Jul 12, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30.026675 OH Primary

Addresses

Primary practice location

265 Benedict Ave
Norwalk, OH 44857-2346

Mailing address

1912 Hayes Ave Ste D
Sandusky, OH 44870-4736
Phone (419) 502-2800

Other practice location 1

263 Farmington Ave
Farmington, CT 06032-1956
Phone (860) 679-2207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190726001864 CT Order and Referring Only - DentistPractitioner - Dentist 1254667330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.026675OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients
Family Health Services of Erie County Past Accepting new patients

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1562889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1295387983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 HAYES AVE STE D",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704736",
            "telephone_number": "419-502-2800",
            "fax_number": "419-502-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 BENEDICT AVE",
            "city": "NORWALK",
            "state": "OH",
            "postal_code": "448572346",
            "telephone_number": "419-502-2800",
            "fax_number": "419-502-2821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060321956",
            "country_code": "US",
            "telephone_number": "860-679-2207",
            "fax_number": "860-679-1363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHOLEKAR",
        "first_name": "AGNISH",
        "middle_name": "MAHESH",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-12",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.026675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, OH

Sources for this page

Verify at the official NPI Registry.