Brian P Radulovich, DMD MSD INC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

17493 Issued in OH

Practice address

8247 Columbia Road
Olmsted Falls, OH 44138

Phone

(440) 235-1777

Fax

(440) 235-5610

NPI assigned

Dec 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497819197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8247 COLUMBIA ROAD",
            "city": "OLMSTED FALLS",
            "state": "OH",
            "postal_code": "44138",
            "telephone_number": "440-235-1777",
            "fax_number": "440-235-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8247 COLUMBIA ROAD",
            "city": "OLMSTED FALLS",
            "state": "OH",
            "postal_code": "44138",
            "telephone_number": "440-235-1777",
            "fax_number": "440-235-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADULOVICH",
        "first_name": "BRIAN",
        "middle_name": "P",
        "credential": "DMD MSD INC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OH",
            "license": "17493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parma Community General Hospital Association (Community Express Care of Parma Hospital)
• Jeanine A Peters, D.P.M.
• Stella Pietka, C.O.T.A.
• Allison Gareau Poore, M.A., CCC-SLP
• PPC-DDM LLC (Community Express Care of Parma Hospital)
• Traci Sue Range, PTA
• Deborah A Rapchak, L.P.N.
• Diane Marie Reese, RN
• Carolyn Sue Rodecker, LPCC-SUPV, LCDCIII
• Lidia Russo, MSN CNP

• Orthodontics and Dentofacial Orthopedics Dentistry in Olmsted Falls, OH
• Providers in Olmsted Falls, OH by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Ohio

• 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.

Verify at the official NPI Registry.