Individual provider Active NPI

Roland Mejares Carreon, DDS

  • Student in an Organized Health Care Education/Training Program
  • Beachwood, OH
National Provider Identifier
1295667566
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
RES.005111 Issued in OH
Practice address
22901 Millcreek Blvd
Beachwood, OH 44122-5728
Phone
(216) 377-6050
NPI assigned
Jun 1, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X RES.005111 OH Primary

Addresses

Primary practice location

22901 Millcreek Blvd
Beachwood, OH 44122-5728

Mailing address

22901 Millcreek Blvd
Beachwood, OH 44122-5728
Phone (216) 377-6050

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
RES.005111OHMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1780272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1295667566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22901 MILLCREEK BLVD",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225728",
            "telephone_number": "216-377-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22901 MILLCREEK BLVD",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225728",
            "telephone_number": "216-377-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARREON",
        "first_name": "ROLAND",
        "middle_name": "MEJARES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-01",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "RES.005111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.