NPIMap

Organization Active NPI

Michael D Wasco DDS LLC

  • General Practice Dentistry
  • Canal Fulton, OH
National Provider Identifier
1407146079
Registry record updated Apr 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.022812 Issued in OH
Legal business name
MICHAEL D WASCO DDS LLC
Practice address
987C Cherry St E
Canal Fulton, OH 44614-9609
Phone
(330) 854-4897
NPI assigned
Apr 15, 2011
Last updated
Apr 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2011

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

Authorized official

Name
Michael D WascoNPI 1811150824
Title
Dentist/Owner
Phone
(330) 854-5897

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 Dentistry 1223G0001X 30.022812 OH Primary

Addresses

Primary practice location

987C Cherry St E
Canal Fulton, OH 44614-9609

Mailing address

987C Cherry St E
P.O Box 346
Canal Fulton, OH 44614-9609
Phone (330) 854-4897

National Provider Directory

National Provider Directory

Locations

987 Cherry St E
Unit C
Canal Fulton, OH 44614
Phone (330) 854-1337

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302825600000",
    "number": "1407146079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "987C CHERRY ST E",
            "address_2": "P.O BOX 346",
            "city": "CANAL FULTON",
            "state": "OH",
            "postal_code": "446149609",
            "telephone_number": "330-854-4897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "987C CHERRY ST E",
            "city": "CANAL FULTON",
            "state": "OH",
            "postal_code": "446149609",
            "telephone_number": "330-854-4897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D WASCO DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-15",
        "last_updated": "2011-04-15",
        "status": "A",
        "authorized_official_last_name": "WASCO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "330-854-5897"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.022812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canal Fulton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2011; 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.