Individual provider Active NPI

Thomas Anthony Dechellis, D.D.S.

  • Dentist
  • Youngstown, OH
National Provider Identifier
1508206798
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.023961 Issued in OH
Practice address
60 Marwood Circle
Youngstown, OH 44512
Phone
(330) 726-8060
NPI assigned
Jul 2, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.023961 OH Primary

Addresses

Primary practice location

60 Marwood Circle
Youngstown, OH 44512

Mailing address

60 Marwood Circle
Youngstown, OH 44512

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
I20150611003301 OH Order and Referring Only - DentistPractitioner - Dentist 6204157597

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.023961OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas a Dechellis DDS, LLC CurrentSince Dec 24, 2023 Accepting new patients
Donald a Dechellis DDS Inc Dentist Past Accepting new patients

Locations

60 Marwood Cir
Youngstown, OH 44512
Phone (330) 726-8060

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": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422921600000",
    "number": "1508206798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MARWOOD CIRCLE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "44512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MARWOOD CIRCLE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "44512",
            "telephone_number": "330-726-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECHELLIS",
        "first_name": "THOMAS",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-02",
        "last_updated": "2015-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.023961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.