NPIMap

Organization Active NPI

Doherty DDS, and Paulus DDS LLC

  • General Practice Dentistry
  • Massillon, OH
National Provider Identifier
1306149430
Registry record updated Dec 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.014457 Issued in OH
Legal business name
DOHERTY DDS, AND PAULUS DDS LLC
Practice address
711 Lincoln Way E
Massillon, OH 44646-6829
Phone
(330) 833-4746
Fax
(330) 832-9928
NPI assigned
Dec 12, 2010
Last updated
Dec 12, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2010

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

Authorized official

Name
Dr. Jon Douglas Paulus, D.D.S.NPI 1528169455
Title
Dentist
Phone
(330) 833-4746

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30.021964 OH
General Practice Dentistry 1223G0001X 30.014457 OH Primary

Addresses

Primary practice location

711 Lincoln Way E
Massillon, OH 44646-6829

Mailing address

711 Lincoln Way E
Massillon, OH 44646-6829
Phone (330) 833-4746

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1292112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292112000000",
    "number": "1306149430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 LINCOLN WAY E",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446466829",
            "telephone_number": "330-833-4746",
            "fax_number": "330-832-9928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 LINCOLN WAY E",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446466829",
            "telephone_number": "330-833-4746",
            "fax_number": "330-832-9928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOHERTY DDS, AND PAULUS DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-12",
        "last_updated": "2010-12-12",
        "status": "A",
        "authorized_official_last_name": "PAULUS",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "330-833-4746",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.021964",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.014457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2010; 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.