NPIMap

Organization Active NPI

Jennifer Psota Dougherty DDS LLC

Doing business as Westlake Family Dental Care

  • Dentist
  • Westlake, OH
National Provider Identifier
1407159320
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
21039 Issued in OH
Legal business name
JENNIFER PSOTA DOUGHERTY DDS LLC
Doing business as
Westlake Family Dental Care
Practice address
2255 Columbia Rd
Westlake, OH 44145-4102
Phone
(440) 835-0011
Fax
(440) 250-1896
NPI assigned
Dec 15, 2010
Last updated
Sep 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Authorized official

Name
Dr. Jennifer Psota Dougherty, DDSNPI 1962423541
Title
Sole MBR
Phone
(440) 835-0011

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 21039 OH Primary

Addresses

Primary practice location

2255 Columbia Rd
Westlake, OH 44145-4102

Mailing address

2255 Columbia Rd
Westlake, OH 44145-4102
Phone (440) 835-0011

Other names 1

  • Westlake Family Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

2255 Columbia Rd
Westlake, OH 44145
Phone (440) 835-0011

Practitioners & affiliated clinicians

Practitioners 1

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": "1292371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1407159320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 COLUMBIA RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441454102",
            "telephone_number": "440-835-0011",
            "fax_number": "440-250-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 COLUMBIA RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441454102",
            "telephone_number": "440-835-0011",
            "fax_number": "440-250-1896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER PSOTA DOUGHERTY DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-15",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "PSOTA DOUGHERTY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "440-835-0011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "21039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westlake Family Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; 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.