Active NPI
Adam Matthew Secret, DDS
- Dentist
- Canton, OH
National Provider Identifier
1609493808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- RES.004248
- Practice address
- 1320 Mercy Dr NW
Canton, OH 44708-2641 - Phone
- (330) 447-1595
- NPI assigned
- Jul 3, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | RES.004248 | OH | Primary |
Addresses
Primary practice location
1320 Mercy Dr NW
Canton, OH 44708-2641
Mailing address
1320 Mercy Dr NW
Canton, OH 44708-2641
Phone (330) 447-1595
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
| License | State | Type | Specialty |
|---|---|---|---|
| RES.004248 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593734400000",
"number": "1609493808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 MERCY DR NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447082641",
"telephone_number": "330-447-1595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 MERCY DR NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447082641",
"telephone_number": "330-447-1595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SECRET",
"first_name": "ADAM",
"middle_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-03",
"last_updated": "2020-07-03",
"certification_date": "2020-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "RES.004248",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.