Dental Studio of Avon Lake LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DENTAL STUDIO OF AVON LAKE LLC

Practice address

32713 Walker Rd
Avon Lake, OH 44012-2232

Phone

(440) 933-7950

NPI assigned

Jun 13, 2019

Last updated

Jun 13, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charlyne Jungermann

Title

Office Manager

Phone

(440) 899-7950

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560384000000",
    "number": "1699335570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32713 WALKER RD",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440122232",
            "telephone_number": "440-933-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32713 WALKER RD",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440122232",
            "telephone_number": "440-933-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL STUDIO OF AVON LAKE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-13",
        "last_updated": "2019-06-13",
        "status": "A",
        "authorized_official_last_name": "JUNGERMANN",
        "authorized_official_first_name": "CHARLYNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "440-899-7950"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1497180889",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1326136896",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Dentalstudio",
            "affiliation": "N",
            "address_1": "32713 Walker Rd",
            "city": "Avon Lake",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440122232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Providers in Avon Lake, OH by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.