Individual provider Active NPI

Mark Joseph Kolosionek, D.D.S.

  • Dentist
  • Hudson, OH
National Provider Identifier
1346436631
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18142 Issued in OH
Practice address
45 Milford Dr Ste 17
Hudson, OH 44236-2750
Phone
(330) 650-4558
Fax
(330) 650-6466
NPI assigned
Sep 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 18142 OH Primary

Addresses

Primary practice location

45 Milford Dr Ste 17
Hudson, OH 44236-2750

Mailing address

45 Milford Dr Ste 17
Hudson, OH 44236-2750
Phone (330) 650-4558

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
18142OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark J Kolosionek DDS & Cara L Fawcett DDS Inc Dentist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1346436631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 MILFORD DR STE 17",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442362750",
            "telephone_number": "330-650-4558",
            "fax_number": "330-650-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MILFORD DR STE 17",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442362750",
            "telephone_number": "330-650-4558",
            "fax_number": "330-650-6466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLOSIONEK",
        "first_name": "MARK",
        "middle_name": "JOSEPH",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "18142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; 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.