Richard Neil Sundheimer, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30-018893 Issued in OH

Practice address

4181 Holiday St NW
Canton, OH 44718-2531

Phone

(330) 493-1605

Fax

(330) 493-9308

NPI assigned

Oct 20, 2006

Last updated

Nov 14, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Institute of Jaw and Facial Surgery Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Canton, OH
  • NPI 1689647018
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226620800000",
    "number": "1609958198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4181 HOLIDAY ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182531",
            "telephone_number": "330-493-1605",
            "fax_number": "330-493-9308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4181 HOLIDAY ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182531",
            "telephone_number": "330-493-1605",
            "fax_number": "330-493-9308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDHEIMER",
        "first_name": "RICHARD",
        "middle_name": "NEIL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2008-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30-018893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0733255",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jammie Sumpter
• Melva Sun
• Sunbow Mental Health & Wellness LLC
• Kent Ryan Sundheimer, RN
• Laiken Lynn Sundheimer, PMHNP-BC
• Madhavi Sunkar, MD
• Surgical Associates of Canton, Inc.
• Deepthi Surineni
• Juanita Nicole Surrell
• Gregory John Susko, R.PH.

• Oral and Maxillofacial Surgery (Dentist) in Canton, OH
• Providers in Canton, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.