Individual provider Active NPI

Michael Mark Lepore, D.D.S

  • General Practice Dentistry
  • Lyndhurst, OH
National Provider Identifier
1669510756
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.017191 Issued in OH
Practice address
5576 Mayfield Rd
Lyndhurst, OH 44124-2928
Phone
(440) 442-2901
Fax
(440) 442-1932
NPI assigned
Feb 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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 30.017191 OH Primary

Addresses

Primary practice location

5576 Mayfield Rd
Lyndhurst, OH 44124-2928

Mailing address

5576 Mayfield Rd
Lyndhurst, OH 44124-2928
Phone (440) 442-2901

Other identifiers 2

IdentifierTypeStateIssuer
2772870MedicaidOH
03-0401716OtherOHTAXPAYER ID NUMBER

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
30.017191OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mitchell Scher D.D.S Lyndhurst,Inc PastSince Aug 7, 2022 Accepting new patients
M Mark Lepore DDS, 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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1669510756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5576 MAYFIELD RD",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441242928",
            "telephone_number": "440-442-2901",
            "fax_number": "440-442-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5576 MAYFIELD RD",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441242928",
            "telephone_number": "440-442-2901",
            "fax_number": "440-442-1932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEPORE",
        "first_name": "MICHAEL",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.017191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2772870",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXPAYER ID NUMBER",
            "identifier": "03-0401716",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyndhurst, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; 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.