Active NPI
Robert George Newman, DDS
- General Practice Dentistry
- Parma, OH
National Provider Identifier
1386637478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 17107
- Practice address
- 6789 Ridge Rd
Suite 304
Parma, OH 44129-5649 - Phone
- (440) 886-3536
- NPI assigned
- Aug 24, 2005
- Reactivated
- Jun 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 17107 | OH | Primary |
Addresses
Primary practice location
6789 Ridge Rd
Suite 304
Parma, OH 44129-5649
Mailing address
17465 Parkside Dr
North Royalton, OH 44133-5415
Phone (440) 886-3535
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160211001032 | OH | Order and Referring Only - Dentist | 8022312073 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17107 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211328000000",
"number": "1386637478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17465 PARKSIDE DR",
"city": "NORTH ROYALTON",
"state": "OH",
"postal_code": "441335415",
"telephone_number": "440-886-3535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6789 RIDGE RD",
"address_2": "SUITE 304",
"city": "PARMA",
"state": "OH",
"postal_code": "441295649",
"telephone_number": "440-886-3536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWMAN",
"first_name": "ROBERT",
"middle_name": "GEORGE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-24",
"last_updated": "2008-05-21",
"deactivation_date": "2007-06-22",
"reactivation_date": "2007-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "17107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Parma, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.