Active NPI
Vladimir Pastoukh, D.M.D.
- General Practice Dentistry
- Pepper Pike, OH
National Provider Identifier
1508887787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 21639
- Practice address
- 3550 Lander Rd
#140
Pepper Pike, OH 44124-5727 - Phone
- (216) 292-3600
- Fax
- (216) 292-3794
- NPI assigned
- Jul 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 21639 | OH | Primary |
Addresses
Primary practice location
3550 Lander Rd
#140
Pepper Pike, OH 44124-5727
Mailing address
5616 S Greenway CT
Unit D
Highland Heights, OH 44143-1987
Phone (440) 543-9000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21639 | OH | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental & Cosmetic Solutions LLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Pepper Pike, OH
- NPI 1518339514
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508887787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5616 S GREENWAY CT",
"address_2": "UNIT D",
"city": "HIGHLAND HEIGHTS",
"state": "OH",
"postal_code": "441431987",
"telephone_number": "440-543-9000",
"fax_number": "440-543-1562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3550 LANDER RD",
"address_2": "#140",
"city": "PEPPER PIKE",
"state": "OH",
"postal_code": "441245727",
"telephone_number": "216-292-3600",
"fax_number": "216-292-3794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASTOUKH",
"first_name": "VLADIMIR",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "21639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pepper Pike, OH
Sources for this page
- 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.