NPIMap

Organization Active NPI

Dr. Aico H. Watanabe, D.D.S.

  • Dentist
  • Westlake, OH
National Provider Identifier
1508047556
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19899 Issued in OH
Legal business name
DR. AICO H. WATANABE, D.D.S.
Practice address
28899 Center Ridge Road #300
Westlake, OH 44145
Phone
(440) 835-3109
Fax
(440) 835-3180
NPI assigned
Nov 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Authorized official

Name
Dr. Aico H Watanabe, DDSNPI 1457361743
Title
Owner
Phone
(440) 835-3109

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 19899 OH Primary

Addresses

Primary practice location

28899 Center Ridge Road #300
Westlake, OH 44145

Mailing address

28899 Center Ridge Road #300
Westlake, OH 44145
Phone (440) 835-3109

Other identifiers 1

IdentifierTypeStateIssuer
0935911MedicaidOH

Other names 1

  • Aico's Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

29115 Center Ridge Rd
Westlake, OH 44145
Phone (440) 835-3109

28899 Center Ridge Rd
Ste 300
Westlake, OH 44145
Phone (440) 835-3109

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685404800000",
    "number": "1508047556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28899 CENTER RIDGE ROAD #300",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "44145",
            "telephone_number": "440-835-3109",
            "fax_number": "440-835-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28899 CENTER RIDGE ROAD #300",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "44145",
            "telephone_number": "440-835-3109",
            "fax_number": "440-835-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. AICO H. WATANABE, D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-19",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A",
        "authorized_official_last_name": "WATANABE",
        "authorized_official_first_name": "AICO",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-835-3109",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "19899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0935911",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aico's Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Aico's Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.