Newark Periodontics LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

NEWARK PERIODONTICS LLC

Practice address

843 N 21St St Ste 102a
Newark, OH 43055-7274

Phone

(740) 366-7207

NPI assigned

Jul 8, 2019

Organization subpart

No

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

Authorized official

Name

Jason C Stoner, DDS

Title

Member

Phone

(614) 889-8222

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Geoffrey Rodman Bauman, DMD MS

  • Periodontics
  • Newark, OH
  • NPI 1699880260
  NPD (past)
• Maria Cristina Ferriol, DMD

  • Periodontics
  • Dublin, OH
  • NPI 1427127265
  NPD (past)

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562544000000",
    "number": "1306408687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5152 BLAZER PKWY",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430177315",
            "telephone_number": "614-889-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "843 N 21ST ST STE 102A",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430557274",
            "telephone_number": "740-366-7207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWARK PERIODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-08",
        "last_updated": "2019-07-08",
        "status": "A",
        "authorized_official_last_name": "STONER",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "614-889-8222",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "30020951",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Newark Resident Homes

• Periodontics in Newark, OH
• Providers in Newark, OH by specialty
• Periodontics in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; 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.