Individual provider Active NPI

Donald Yezerski, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Cleveland, OH
National Provider Identifier
1467522128
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
15839 Issued in OH
Practice address
7379 Pearl Rd
Suite 2
Cleveland, OH 44130-4898
Phone
(440) 234-1810
Fax
(440) 234-1997
NPI assigned
Nov 9, 2006
Last updated
Jan 17, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 15839 OH
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 15839 OH Primary

Addresses

Primary practice location

7379 Pearl Rd
Suite 2
Cleveland, OH 44130-4898

Mailing address

7379 Pearl Rd
Suite 2
Cleveland, OH 44130-4898
Phone (440) 234-1810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15839OHMDOral and Maxillofacial Surgery (Dentist)

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1467522128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7379 PEARL RD",
            "address_2": "SUITE 2",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441304898",
            "telephone_number": "440-234-1810",
            "fax_number": "440-234-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7379 PEARL RD",
            "address_2": "SUITE 2",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441304898",
            "telephone_number": "440-234-1810",
            "fax_number": "440-234-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEZERSKI",
        "first_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "15839",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "OH",
            "license": "15839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; 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.