Organization Active NPI

Lehky State Dental Providers, LLC

  • Public Health Dentistry
  • Fairlawn, OH
National Provider Identifier
1356066062
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
Legal business name
LEHKY STATE DENTAL PROVIDERS, LLC
Practice address
2820 W Market St Ste 100
Fairlawn, OH 44333-4061
Phone
(330) 864-3331
NPI assigned
Oct 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Authorized official

Name
Tiffany R Creek, CDA
Title
Director
Phone
(330) 224-9528

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223D0001X Primary
Dental Clinic/Center 261QD0000X

Addresses

Primary practice location

2820 W Market St Ste 100
Fairlawn, OH 44333-4061

Mailing address

2820 W Market St Ste 100
Fairlawn, OH 44333-4061
Phone (330) 864-3331

Other practice location 1

220 Windsor Dr
Cortland, OH 44410-2703
Phone (330) 864-3331

Other practice location 2

210 Windsor Dr
Cortland, OH 44410-2703
Phone (330) 864-3331

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL website Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

220 Windsor Dr
Cortland, OH 44410
Phone (330) 637-3909

210 Windsor Dr
Cortland, OH 44410
Phone (330) 638-7004

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1356066062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 W MARKET ST STE 100",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334061",
            "telephone_number": "330-864-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 W MARKET ST STE 100",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334061",
            "telephone_number": "330-864-3331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Windsor Dr",
            "address_purpose": "LOCATION",
            "city": "Cortland",
            "state": "OH",
            "postal_code": "444102703",
            "country_code": "US",
            "telephone_number": "330-864-3331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "210 Windsor Dr",
            "address_purpose": "LOCATION",
            "city": "Cortland",
            "state": "OH",
            "postal_code": "444102703",
            "country_code": "US",
            "telephone_number": "330-864-3331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEHKY STATE DENTAL PROVIDERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "CREEK",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "330-224-9528",
        "authorized_official_credential": "CDA"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "website",
            "affiliation": "N",
            "endpointDescription": "encrypted patient portal",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2820 W Market St Ste 100",
            "city": "Fairlawn",
            "state": "OH",
            "country_code": "US",
            "postal_code": "443334061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.