Organization Active NPI

Gumcare and Implant Specialists LLC - Dr. Basta

  • Periodontics
  • Canton, OH
National Provider Identifier
1457186876
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
GUMCARE AND IMPLANT SPECIALISTS LLC - DR. BASTA
Practice address
4410 Executive Cir NW # a
Canton, OH 44718-2983
Phone
(330) 349-7004
NPI assigned
Sep 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Authorized official

Name
Dr. Karim Basta
Title
Owner
Phone
(330) 494-7004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X Primary

Addresses

Primary practice location

4410 Executive Cir NW # a
Canton, OH 44718-2983

Mailing address

4410 Executive Cir NW # a
Canton, OH 44718-2983
Phone (330) 349-7004

National Provider Directory

National Provider Directory

Locations

4410 Executive Cir NW
#A
Canton, OH 44718
Phone (330) 349-7004

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1725494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1457186876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 EXECUTIVE CIR NW # A",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182983",
            "telephone_number": "330-349-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 EXECUTIVE CIR NW # A",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182983",
            "telephone_number": "330-349-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUMCARE AND IMPLANT SPECIALISTS LLC - DR. BASTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-05",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "BASTA",
        "authorized_official_first_name": "KARIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-494-7004",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.