Individual provider Active NPI

Todd R Dunkle, DDS

  • General Practice Dentistry
  • Sylvania, OH
National Provider Identifier
1619037579
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14429 Issued in OH
Practice address
6357 Monroe Street
Sylvania, OH 43560-1429
Phone
(419) 882-8822
Fax
(419) 882-8829
NPI assigned
Dec 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14429 OH Primary

Addresses

Primary practice location

6357 Monroe Street
Sylvania, OH 43560-1429

Mailing address

6357 Monroe Street
Sylvania, OH 43560-1429
Phone (419) 882-8822

Other identifiers 1

IdentifierTypeStateIssuer
0236917MedicaidOH

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150212001207 OH Order and Referring Only - DentistPractitioner - Dentist 3971828062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14429OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sylvania Dental Group General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619037579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6357 MONROE STREET",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435601429",
            "telephone_number": "419-882-8822",
            "fax_number": "419-882-8829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6357 MONROE STREET",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435601429",
            "telephone_number": "419-882-8822",
            "fax_number": "419-882-8829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNKLE",
        "first_name": "TODD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "14429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0236917",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.