Cleveland Center for Integrative Dentistry by Dr. Pastouk and Associat

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21639 Issued in OH

Legal business name

CLEVELAND CENTER FOR INTEGRATIVE DENTISTRY BY DR. PASTOUK AND ASSOCIAT

Doing business as

Cleveland Center for Integrative Dentistry

Practice address

845 Som Center Rd
Suite a
Mayfield Village, OH 44143-3581

Phone

(216) 777-8844

NPI assigned

Apr 26, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Vladimir Pastouk, D.M.D.

Title

Owner

Phone

(216) 777-8844

Specialties & licenses 1

Addresses

Other names 1

• Cleveland Center for Integrative Dentistry Doing business as

Locations

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461628800000",
    "number": "1639524705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 SOM CENTER RD",
            "address_2": "SUITE A",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441433581",
            "telephone_number": "216-777-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 SOM CENTER RD",
            "address_2": "SUITE A",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441433581",
            "telephone_number": "216-777-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND CENTER FOR INTEGRATIVE DENTISTRY BY DR. PASTOUK AND ASSOCIAT",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-04-26",
        "status": "A",
        "authorized_official_last_name": "PASTOUK",
        "authorized_official_first_name": "VLADIMIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-777-8844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "21639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cleveland Center for Integrative Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Mayfield Village, OH
• Providers in Mayfield Village, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; 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.