NPIMap

Organization Active NPI

John Herbert Gerstenmaier

  • Pediatric Dentistry
  • Fairlawn, OH
National Provider Identifier
1568636660
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
30014537 Issued in OH
Legal business name
JOHN HERBERT GERSTENMAIER
Practice address
3094 West Market St
#260
Fairlawn, OH 44333-3626
Phone
(330) 867-5688
Fax
(330) 867-9921
NPI assigned
Apr 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Authorized official

Name
Dr. John Herbert Gerstenmaier Jr., DDSNPI 1669454302
Title
Owner President
Phone
(330) 867-5688

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 30014537 OH Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 2901010057 MI

Addresses

Primary practice location

3094 West Market St
#260
Fairlawn, OH 44333-3626

Mailing address

3094 West Market St
#260
Fairlawn, OH 44333-3626
Phone (330) 867-5688

Other identifiers 1

IdentifierTypeStateIssuer
0273814MedicaidOH

National Provider Directory

National Provider Directory

Locations

3094 W Market St
Ste 260
Fairlawn, OH 44333
Phone (330) 867-5688

Practitioners & affiliated clinicians

Practitioners 1

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": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1568636660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3094 WEST MARKET ST",
            "address_2": "#260",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333626",
            "telephone_number": "330-867-5688",
            "fax_number": "330-867-9921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3094 WEST MARKET ST",
            "address_2": "#260",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333626",
            "telephone_number": "330-867-5688",
            "fax_number": "330-867-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN HERBERT GERSTENMAIER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "GERSTENMAIER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "HERBERT",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "330-867-5688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30014537",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "2901010057",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0273814",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; 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.