Peter M Maragos, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

20579 Issued in OH

Practice address

206 Pearl Rd
Brunswick, OH 44212-1118

Phone

(330) 273-4867

Fax

(330) 273-4868

NPI assigned

Jul 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218499200000",
    "number": "1336166792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 PEARL RD",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "442121118",
            "telephone_number": "330-273-4867",
            "fax_number": "330-273-4868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 PEARL RD",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "442121118",
            "telephone_number": "330-273-4867",
            "fax_number": "330-273-4868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARAGOS",
        "first_name": "PETER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2008-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "20579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "20579",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert K Makara
• Roman Mamus
• Gabriel Mancini, D.O.
• Robert William Mandel, DDS
• Christina May Manning
• Marc Glassman Inc
• Julianne Marshall
• Amy Terese Martin, PHARM.D.
• Christine Erin Martin, LPCC
• Derrick Francis Martin, LPCC-S

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.