Active NPI
Louis W Susi, DDS,MS
- Endodontics
- Blacklick, OH
National Provider Identifier
1477688653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 21826
- Practice address
- 7334 E Broad St
Suite C
Blacklick, OH 43004-9239 - Phone
- (614) 577-1100
- NPI assigned
- Feb 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 21826 | OH | Primary |
Addresses
Primary practice location
7334 E Broad St
Suite C
Blacklick, OH 43004-9239
Mailing address
7334 E. Broad Street
Suite C
Blacklick, OH 43004
Phone (614) 487-8016
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21826 | OH | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbus Endodontic Specialists | Endodontics | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Endodontics
- Blacklick, OH
- NPI 1609421684
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477688653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7334 E. BROAD STREET",
"address_2": "SUITE C",
"city": "BLACKLICK",
"state": "OH",
"postal_code": "43004",
"telephone_number": "614-487-8016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7334 E BROAD ST",
"address_2": "SUITE C",
"city": "BLACKLICK",
"state": "OH",
"postal_code": "430049239",
"telephone_number": "614-577-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUSI",
"first_name": "LOUIS",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "DDS,MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "OH",
"license": "21826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blacklick, OH
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.