Individual provider Active NPI

John R Vanni, D.D.S.

  • General Practice Dentistry
  • Lyndhurst, OH
National Provider Identifier
1447469036
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-17434 Issued in OH
Practice address
5187 Mayfield Rd
Suite 40
Lyndhurst, OH 44124-2468
Phone
(440) 446-0110
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30-17434 OH Primary

Addresses

Primary practice location

5187 Mayfield Rd
Suite 40
Lyndhurst, OH 44124-2468

Mailing address

5187 Mayfield Rd
Ste 40
Lyndhurst, OH 44124-2466
Phone (440) 446-0110

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
I20160211002852 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5698079606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30-17434OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1447469036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5187 MAYFIELD RD",
            "address_2": "STE 40",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441242466",
            "telephone_number": "440-446-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5187 MAYFIELD RD",
            "address_2": "SUITE 40",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441242468",
            "telephone_number": "440-446-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNI",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-17434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyndhurst, OH

Sources for this page

Verify at the official NPI Registry.