University Suburban Dental Group, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30-01-7418 Issued in OH

Legal business name

UNIVERSITY SUBURBAN DENTAL GROUP, INC

Practice address

1611 S Green Rd
Suite 157
Cleveland, OH 44121-4128

Phone

(216) 381-6521

Fax

(216) 381-9226

NPI assigned

Jan 30, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Laura Jean Kennedy

Title

Practice Administrator

Phone

(216) 381-6521

Specialties & licenses 1

Addresses

Other names 1

• Michael E Skerl DDS Former legal business name

Locations

Practitioners 2

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

• Alexis Marie Plucinsky, DMD

  • General Practice Dentistry
  • South Euclid, OH
  • NPI 1730879032
  NPD (past)
• Michael E Skerl, DDS

  • General Practice Dentistry
  • South Euclid, OH
  • NPI 1710918727
  NPD (past)

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247184000000",
    "number": "1326019233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 S GREEN RD",
            "address_2": "SUITE 157",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441214128",
            "telephone_number": "216-381-6521",
            "fax_number": "216-381-9226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 S GREEN RD",
            "address_2": "SUITE 157",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441214128",
            "telephone_number": "216-381-6521",
            "fax_number": "216-381-9226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY SUBURBAN DENTAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-30",
        "last_updated": "2009-07-10",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "216-381-6521",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-01-7418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael E Skerl DDS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• General Practice Dentistry in Cleveland, OH
• Providers in Cleveland, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; 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.