Dynasty Destination Transportation Service LLC

Primary specialty

DriverTaxonomy code 172A00000X

Legal business name

DYNASTY DESTINATION TRANSPORTATION SERVICE LLC

Practice address

3067 Albion Rd
Cleveland, OH 44120-2705

Phone

(216) 773-0434

NPI assigned

Dec 29, 2020

Organization subpart

No

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

Authorized official

Name

Carletta McDougal

Title

Ceo

Phone

(216) 773-0434

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609200000000",
    "number": "1689261257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3067 ALBION RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441202705",
            "telephone_number": "216-773-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3067 ALBION RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441202705",
            "telephone_number": "216-773-0434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNASTY DESTINATION TRANSPORTATION SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A",
        "authorized_official_last_name": "MCDOUGAL",
        "authorized_official_first_name": "CARLETTA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "216-773-0434"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRANSPORTATION",
            "identifier": "2167730434",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Clinton Dyer, MD
• Kathryn Dyhdalo
• Rebecca Dykes, APRN
• Sugar Rae Dykes
• Cassandra Dykin
• La Rasha Dyson, SW-A
• Danielle Dziak, RN
• Mary Benton Dziak
• Michael Ian Dziat, AGNP
• Jessica Dziedzicki, AU.D.

• Driver in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Driver in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.

Verify at the official NPI Registry.