Individual provider Active NPI

Levan Jangirashvili

  • General Practice Dentistry
  • North Canton, OH
National Provider Identifier
1417199233
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.023048 Issued in OH
Practice address
911 N Main St
North Canton, OH 44720-1919
Phone
(330) 498-9900
NPI assigned
Mar 25, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2651 OH
General Practice Dentistry 1223G0001X 30.023048 OH Primary

Addresses

Primary practice location

911 N Main St
North Canton, OH 44720-1919

Mailing address

911 N Main St
North Canton, OH 44720-1919
Phone (330) 498-9900

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160218002275 OH Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 9830494426

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2651OHMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1417199233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 N MAIN ST",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447201919",
            "telephone_number": "330-498-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 N MAIN ST",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447201919",
            "telephone_number": "330-498-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANGIRASHVILI",
        "first_name": "LEVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-25",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "2651",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.023048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Canton, OH

Sources for this page

Verify at the official NPI Registry.