Jon Douglas Paulus, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

30-01447 Issued in OH

Practice address

711 Lincoln Way E
Massillon, OH 44646-6829

Phone

(330) 833-4746

Fax

(330) 832-9928

NPI assigned

Sep 25, 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

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Doherty DDS, and Paulus DDS LLC

  • General Practice Dentistry
  • Massillon, OH
  • NPI 1306149430
  NPD (past) Authorized official
• J. Douglas Paulus D.D.S. Inc.

  • Dentist
  • Massillon, OH
  • NPI 1457434755
  NPD (past) Authorized official

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528169455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 LINCOLN WAY E",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446466829",
            "telephone_number": "330-833-4746",
            "fax_number": "330-832-9928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 LINCOLN WAY E",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446466829",
            "telephone_number": "330-833-4746",
            "fax_number": "330-832-9928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULUS",
        "first_name": "JON",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-01447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Patterson
• Ian Patterson, MD
• Jami Lyn Paul, O.D.
• Rayelle L Paulson
• Daniel Paulus, D.D.S
• Janet Anne Payne, CRNA
• Lawrence N Payne, MD
• PCS Sleep Center, LLC
• Melissa Peck, CNP
• Pediatric and Family Medicine Health Care Inc.

• Dentist in Massillon, OH
• Providers in Massillon, OH by specialty
• Dentist 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.