Individual provider Active NPI

Kyle Joseph Radin, DMD

  • Dentist
  • Avon, OH
National Provider Identifier
1609369495
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.025478 Issued in OH
Practice address
36855 American Way Ste 2a
Avon, OH 44011-4055
Phone
(440) 695-3353
NPI assigned
Jun 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.025478 OH Primary

Addresses

Primary practice location

36855 American Way Ste 2a
Avon, OH 44011-4055

Mailing address

3011 Stonebrooke LN
Medina, OH 44256-5308
Phone (216) 394-9657

Other practice location 1

2086 Romig Rd
Akron, OH 44320-3820
Phone (330) 753-3007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30.025478OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Radin Dental LLC Current Accepting new patients
Dr Nassif and Associates Inc Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1609369495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 STONEBROOKE LN",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565308",
            "telephone_number": "216-394-9657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36855 AMERICAN WAY STE 2A",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440114055",
            "telephone_number": "440-695-3353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2086 Romig Rd",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443203820",
            "country_code": "US",
            "telephone_number": "330-753-3007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADIN",
        "first_name": "KYLE",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-07",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.025478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; 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.