Jaclyn Radefeld, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.024637 Issued in OH

Practice address

6688 Ridge Rd
Suite 1435
Parma, OH 44129-5706

Phone

(440) 884-1970

Fax

(440) 884-3294

NPI assigned

Nov 13, 2015

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1447372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447372800000",
    "number": "1477927457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6688 RIDGE RD",
            "address_2": "SUITE 1435",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441295706",
            "telephone_number": "440-884-1970",
            "fax_number": "440-884-3294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6688 RIDGE RD",
            "address_2": "SUITE 1435",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441295706",
            "telephone_number": "440-884-1970",
            "fax_number": "440-884-3294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADEFELD",
        "first_name": "JACLYN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-13",
        "last_updated": "2015-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.024637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabitha Lynn Quinn, LSW
• Angela Quinones
• R. Rubin Gutarts, D.D.S., M.S., Inc.
• Nicole Racey
• David Ellis Radebaugh, M.D.
• Randall W. Radefeld, DDS
• Brian Paul Radesic, CRNA, DNP
• Nikola Radojkovic, PHARMD
• Raisa Lerner MD Inc
• Kathleen M Rak

• General Practice Dentistry in Parma, OH
• Providers in Parma, 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 Nov 13, 2015; 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.