Organization Active NPI

NJK Premier Family Dental, Inc.

  • General Practice Dentistry
  • Strongsville, OH
National Provider Identifier
1366467284
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NJK PREMIER FAMILY DENTAL, INC.
Practice address
13477 Prospect Rd
Suite 212
Strongsville, OH 44149-3867
Phone
(440) 268-0768
Fax
(440) 268-0739
NPI assigned
Jul 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Nadeem J Koussa, DDSNPI 1194740001
Title
President
Phone
(440) 268-0768

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

13477 Prospect Rd
Suite 212
Strongsville, OH 44149-3867

Mailing address

13477 Prospect Rd
Suite 212
Strongsville, OH 44149-3867
Phone (440) 268-0768

National Provider Directory

National Provider Directory

Locations

13477 Prospect Rd
Ste 212
Strongsville, OH 44149
Phone (440) 268-0768

Practitioners & affiliated clinicians

Practitioners 1

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": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366467284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13477 PROSPECT RD",
            "address_2": "SUITE 212",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441493867",
            "telephone_number": "440-268-0768",
            "fax_number": "440-268-0739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13477 PROSPECT RD",
            "address_2": "SUITE 212",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441493867",
            "telephone_number": "440-268-0768",
            "fax_number": "440-268-0739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NJK PREMIER FAMILY DENTAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOUSSA",
        "authorized_official_first_name": "NADEEM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-268-0768",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Strongsville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.