Jeffrey Mark Danczak, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

30-024612 Issued in OH

Practice address

1727 Streetsboro PLZ
Streetsboro, OH 44241-5635

Phone

(330) 626-3814

NPI assigned

Oct 9, 2015

Sex

Male

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Streetsboro Dental

  • General Practice Dentistry
  • Streetsboro, OH
  • NPI 1013386739
  NPD (past) Authorized official
• Streetsboro Dental Partners Inc

  • General Practice Dentistry
  • Streetsboro, OH
  • NPI 1649437336
  NPD (past)

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1487025938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23220 CHAGRIN BLVD",
            "address_2": "APT 433",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225408",
            "telephone_number": "216-280-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 STREETSBORO PLZ",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442415635",
            "telephone_number": "330-626-3814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANCZAK",
        "first_name": "JEFFREY",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-09",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-024612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Clark, LISW
• Close to Home Nursing Care and Rehab
• Stephane C Cross, RN
• Wyatt Allen Crowell, DDS
• Bailee R D'Amore-Dicamillo
• Susan E Daris, O.D.
• Hanna Darling, OTR/L
• Jaymini D Dave
• Deidra Davis
• Frank Davis

• Dentist in Streetsboro, OH
• Providers in Streetsboro, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.