Doc Raiffe Management Group LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19625 Issued in OH

Legal business name

DOC RAIFFE MANAGEMENT GROUP LLC

Doing business as

Tri-City Dental Group

Practice address

17601 W 130TH St
Suite 101
North Royalton, OH 44133-5966

Phone

(440) 582-0550

NPI assigned

Jul 28, 2015

Last updated

Jul 28, 2015By 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

Opal Anderson

Title

Regional Manager

Phone

(440) 823-6790

Specialties & licenses 1

Addresses

Other names 1

• Tri-City Dental Group Doing business as

Locations

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438041600000",
    "number": "1578948840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17601 W 130TH ST",
            "address_2": "SUITE 101",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441335966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17601 W 130TH ST",
            "address_2": "SUITE 101",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441335966",
            "telephone_number": "440-582-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOC RAIFFE MANAGEMENT GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-28",
        "last_updated": "2015-07-28",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "OPAL",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "440-823-6790"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "19625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri-City Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Disabato, PHD
• Discount Drug Mart Inc (Discount Drug Mart)
• Rebecca Jane Dister, R.D., L.D.
• Distinctive Eyewear Inc.
• Jordyn Dlugonski, PT, DPT
• Anna Docktor
• Donald Powers DDS,Inc.
• Melanie Donoughe
• Jacqueline Nicole Dover, MSSA, LSW
• Dr Anita M Soto O.D. Inc.

• General Practice Dentistry in North Royalton, OH
• Providers in North Royalton, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; 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.