Kenneth Richard Depolo, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

30.026359 Issued in OH

Practice address

303 Graham Road
Cuyahoga Falls, OH 44223

Phone

(330) 928-8837

NPI assigned

Jan 25, 2021

Last updated

Aug 26, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• TD Dental LLC

  • Public Health Dentistry
  • Akron, OH
  • NPI 1932964400
  NPD (past)

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1720678618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 GRAHAM ROAD",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "44223",
            "telephone_number": "330-928-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 GRAHAM ROAD",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "44223",
            "telephone_number": "330-928-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPOLO",
        "first_name": "KENNETH",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-25",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.026359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carsen Shea Dennis
• Dental Professionals Cleveland-Nouneh, Inc.
• Dental Services of Ohio (ImmediaDent)
• Datinder Bir Singh Deo, MD
• Tammi Ann Depascale
• Irene E Dettmer, CRNP
• Meaghan Marie Devany, OD
• James Edward Deykes, D.O.
• Harkanwal Dhillon, M.D.
• Amy Dice

• Dentist in Cuyahoga Falls, OH
• Providers in Cuyahoga Falls, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.