Individual provider Active NPI

Joseph A Kunchik, DDS

  • General Practice Dentistry
  • Cleveland, OH
National Provider Identifier
1487668356
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21134 Issued in OH
Practice address
3545 Ridge Rd
Unit 2
Cleveland, OH 44102
Phone
(216) 961-6860
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 21134 OH Primary

Addresses

Primary practice location

3545 Ridge Rd
Unit 2
Cleveland, OH 44102

Mailing address

27054 Courtland Meadows
Westlake, OH 44145
Phone (440) 801-1302

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20181022001466 OH Practitioner - Oral Surgery 3971824210 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21134OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lorain County Health & Dentistry CurrentSince Aug 21, 2018 Accepting new patients
Lorain County Health & Dentistry CurrentSince Aug 21, 2018 Accepting new patients

Locations

105 Louden Ct
Elyria, OH 44035

1205 Broadway
Lorain, OH 44052

260 S Main St
Oberlin, OH 44074

Interoperability endpoints

  • Direct secure messaging: joseph.kunchik.p11@direct.loraincountyhealth.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1487668356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27054 COURTLAND MEADOWS",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "44145",
            "telephone_number": "440-801-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 RIDGE RD",
            "address_2": "UNIT 2",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44102",
            "telephone_number": "216-961-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNCHIK",
        "first_name": "JOSEPH",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "21134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.