NPIMap

Organization Active NPI

John a. Gennantonio, DDS and Kathryn Lubitz Stewart, DDS, LLC

  • Pediatric Dentistry
  • Cincinnati, OH
National Provider Identifier
1508185802
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
30.019420 Issued in OH
Legal business name
JOHN A. GENNANTONIO, DDS AND KATHRYN LUBITZ STEWART, DDS, LLC
Doing business as
Sea of Smiles
Practice address
1319 Nagel Rd
Cincinnati, OH 45255-3101
Phone
(513) 474-6777
Fax
(513) 474-2326
NPI assigned
May 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Authorized official

Name
Mrs. Traci Cain
Title
Business Assistant
Phone
(513) 474-6777

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 30.022659 OH
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 30.019420 OH Primary

Addresses

Primary practice location

1319 Nagel Rd
Cincinnati, OH 45255-3101

Mailing address

1319 Nagel Road
Cincinnati, OH 45255
Phone (513) 474-6777

Other identifiers 3

IdentifierTypeStateIssuer
0924807MedicaidOH
3047410MedicaidOH
2830146MedicaidOH

Other names 1

  • Sea of Smiles Doing business as

National Provider Directory

National Provider Directory

Locations

1319 Nagel Rd
Cincinnati, OH 45255
Phone (513) 474-6777

Practitioners & affiliated clinicians

Practitioners 3

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": "1274832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461196800000",
    "number": "1508185802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 NAGEL ROAD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45255",
            "telephone_number": "513-474-6777",
            "fax_number": "513-474-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 NAGEL RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452553101",
            "telephone_number": "513-474-6777",
            "fax_number": "513-474-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN A. GENNANTONIO, DDS AND KATHRYN LUBITZ STEWART, DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-26",
        "last_updated": "2016-04-21",
        "status": "A",
        "authorized_official_last_name": "CAIN",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "BUSINESS ASSISTANT",
        "authorized_official_telephone_number": "513-474-6777",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.022659",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.019420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0924807",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3047410",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2830146",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sea of Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; 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.