Organization Active NPI

Dr Kmiecks Dental Health Service

  • General Practice Dentistry
  • Parma Heights, OH
National Provider Identifier
1699877597
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DR KMIECKS DENTAL HEALTH SERVICE
Practice address
7057 W 130 Street
Parma Heights, OH 44130
Phone
(440) 888-9755
Fax
(440) 888-8763
NPI assigned
Sep 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kenneth T Kmieck, DDS
Title
Owner President
Phone
(440) 888-9755

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

7057 W 130 Street
Parma Heights, OH 44130

Mailing address

7057 W 130 Street
Parma Heights, OH 44130
Phone (440) 888-9755

Other identifiers 1

IdentifierTypeStateIssuer
0281770MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Dr Kmiecks Dental Health Service2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699877597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7057 W 130 STREET",
            "city": "PARMA HEIGHTS",
            "state": "OH",
            "postal_code": "44130",
            "telephone_number": "440-888-9755",
            "fax_number": "440-888-8763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7057 W 130 STREET",
            "city": "PARMA HEIGHTS",
            "state": "OH",
            "postal_code": "44130",
            "telephone_number": "440-888-9755",
            "fax_number": "440-888-8763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR KMIECKS DENTAL HEALTH SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KMIECK",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER  PRESIDENT",
        "authorized_official_telephone_number": "440-888-9755",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0281770",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parma Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.