Northeast Ohio Center for Dental Sleep Medicine LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

OH 30-023233 Issued in OH

Legal business name

NORTHEAST OHIO CENTER FOR DENTAL SLEEP MEDICINE LLC

Practice address

22901 Millcreek Blvd
Suite #140
Beachwood, OH 44122-5728

Phone

(216) 831-1170

NPI assigned

Feb 25, 2017

Last updated

Nov 28, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Douglas E Desatnik, DDSNPI 1417269820

Title

President

Phone

(216) 831-1170

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Douglas E Desatnik, DDS

  • Dentist
  • Beachwood, OH
  • NPI 1417269820
  NPD (past) Authorized official

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

{
    "created_epoch": "1487980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511827200000",
    "number": "1558801480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22901 MILLCREEK BLVD",
            "address_2": "SUITE #140",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225728",
            "telephone_number": "216-831-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22901 MILLCREEK BLVD",
            "address_2": "SUITE #140",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225728",
            "telephone_number": "216-831-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST OHIO CENTER FOR DENTAL SLEEP MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-25",
        "last_updated": "2017-11-28",
        "status": "A",
        "authorized_official_last_name": "DESATNIK",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-831-1170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OH",
            "license": "OH 30-023233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "1417269820",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Northern Ohio Medical Specialists, LLC (NOMS Healthcare)
• Novacare Rehabilitation of Ohio, Inc. (NovaCare Rehabilitation)

• Dental Clinic/Center in Beachwood, OH
• Providers in Beachwood, OH by specialty
• Dental Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; 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.