Individual provider Active NPI

Daniel Shertok, D.D.S.

  • Dentist
  • Cincinnati, OH
National Provider Identifier
1407085335
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.024582 Issued in OH
Practice address
19 Garfield PL Ste 414
Cincinnati, OH 45202-4309
Phone
(513) 721-5924
NPI assigned
Jul 13, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN19188 FL
General Practice Dentistry 1223G0001X 63041 CA
Dentist 122300000X 30.024582 OH Primary

Addresses

Primary practice location

19 Garfield PL Ste 414
Cincinnati, OH 45202-4309

Mailing address

19 Garfield PL Ste 414
Cincinnati, OH 45202-4309
Phone (513) 721-5924

Other practice location 1

7125 Reading Rd
Cincinnati, OH 45237-3806
Phone (513) 631-2224

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
63041CAMDClinical Social Worker
30.024582OHMDDentist
DN19188FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Edward E Loftspring DDS Inc General Practice PastSince Jul 24, 2022 Accepting new patients
Valley Dental LLC General Practice Past Accepting new patients

Organizations & group practices 2

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": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407085335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 GARFIELD PL STE 414",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452024309",
            "telephone_number": "513-721-5924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 GARFIELD PL STE 414",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452024309",
            "telephone_number": "513-721-5924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7125 Reading Rd",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452373806",
            "country_code": "US",
            "telephone_number": "513-631-2224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHERTOK",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN19188",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63041",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.024582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.