Thomas Robert Dejak, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

037190 Issued in GA

Practice address

3700 Park East Dr
4TH Floor
Cleveland, OH 44122-4339

Phone

(216) 763-3106

NPI assigned

Sep 5, 2007

Last updated

Sep 5, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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)

Enrolled

Credentials

Doctor of Medicine

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.

• Ear, Nose & Throat Plastic Surgery Center

  • Otolaryngology/Facial Plastic Surgery Physician
  • Douglasville, GA
  • NPI 1821163577
  NPD (past)
• Milton Hall Surgical Associates, LLC

  • Specialist
  • Alpharetta, GA
  • NPI 1649238460
  NPD (past)
• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  NPD (past)

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1609060318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 ROSWELL COMMONS CIR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761594",
            "telephone_number": "770-649-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 PARK EAST DR",
            "address_2": "4TH FLOOR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441224339",
            "telephone_number": "216-763-3106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJAK",
        "first_name": "THOMAS",
        "middle_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "037190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Deioma, CNM
• Larry Deitcher
• Sarah Katherine Deitz, MD
• Diana Lin Deitzer, DO
• Irene L Dejak, MD
• Caroline Nathalie Dejean, M.D.
• Liza M Dejesus, LSW
• Lynette Dejesus
• Norelis Dejesus, CDCA
• Carl J Dejohn, LPCC

• Otolaryngology Physician in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Otolaryngology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.