Active NPI
Marc Allen Kanetsky, DDS
- Dentist
- Sidney, OH
National Provider Identifier
1699283523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30.025289
- Practice address
- 1445 N Main Ave
Sidney, OH 45365-1782 - Phone
- (937) 492-9983
- NPI assigned
- Jan 12, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30.025289 | OH | Primary |
Addresses
Primary practice location
1445 N Main Ave
Sidney, OH 45365-1782
Mailing address
374 Center St
Hubbard, OH 44425-1546
Phone (330) 301-0768
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30.025289 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515715200000",
"number": "1699283523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "374 CENTER ST",
"city": "HUBBARD",
"state": "OH",
"postal_code": "444251546",
"telephone_number": "330-301-0768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1445 N MAIN AVE",
"city": "SIDNEY",
"state": "OH",
"postal_code": "453651782",
"telephone_number": "937-492-9983"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANETSKY",
"first_name": "MARC",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-01-12",
"last_updated": "2018-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30.025289",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sidney, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.