Kent Angelo Caserta, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30 01527 Issued in OH

Practice address

38530 Lake Shore Blvd
Willoughby, OH 44094-7163

Phone

(440) 953-1733

Fax

(440) 946-1650

NPI assigned

Jul 29, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kent a. Caserta, DDS., Inc.

  • General Practice Dentistry
  • Willoughby, OH
  • NPI 1336307784
  NPD (past) Authorized official
• Ana & Anthony Dental LLC

  dba Lakeshore Family Dental

  • Dental Clinic/Center
  • Willoughby, OH
  • NPI 1699545111
  NPD (past)

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447265392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38530 LAKE SHORE BLVD",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440947163",
            "telephone_number": "440-953-1733",
            "fax_number": "440-946-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38530 LAKE SHORE BLVD",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440947163",
            "telephone_number": "440-953-1733",
            "fax_number": "440-946-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASERTA",
        "first_name": "KENT",
        "middle_name": "ANGELO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30 01527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne McDonald Carrol, M.D.
• Cierrah R. R. Carter, APRN-CNP, FNP-C
• Demetrius Carter, QMHS
• Dale A Casamatta, R.N.
• Majken E Casamatta, R.N.
• Michelle Antoinette Casey
• Leslie Cash, QMHS
• Jane Cassano
• Daniella N Cassese, QMHS
• Gabrielle Castellanos, LMT

• General Practice Dentistry in Willoughby, OH
• Providers in Willoughby, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.