Individual provider Active NPI

Bethany L Doroghazi, D.M.D.

  • Dentist
  • Cleveland, OH
National Provider Identifier
1750646188
Registry record updated Apr 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30-023688 Issued in OH
Practice address
8300 Hough Ave
Cleveland, OH 44103-4247
Phone
(216) 231-7700
NPI assigned
Jul 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30-023688 OH Primary

Addresses

Primary practice location

8300 Hough Ave
Cleveland, OH 44103-4247

Mailing address

6815 Thornapple Dr
Gates Mills, OH 44040-9644
Phone (440) 488-6744

Other identifiers 1

IdentifierTypeStateIssuer
0089125MedicaidOH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170426002864 OH Practitioner - Oral Surgery 9436399243 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30-023688OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lorain County Health & Dentistry Current Accepting new patients
Lorain County Health & Dentistry Dentist CurrentSince Jul 7, 2020 Accepting new patients
Lorain County Health & Dentistry CurrentSince Jul 7, 2020 Accepting new patients

Locations

105 Louden Ct
Elyria, OH 44035

3745 Grove Ave
Lorain, OH 44055
Phone (440) 240-1901

1205 Broadway
Lorain, OH 44052

260 S Main St
Oberlin, OH 44074

Interoperability endpoints

  • Direct secure messaging: bdoroghazi769425@direct.ochin.org
  • Direct secure messaging: bethany.doroghazi.p11@direct.loraincountyhealth.nextgenshare.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491696000000",
    "number": "1750646188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6815 THORNAPPLE DR",
            "city": "GATES MILLS",
            "state": "OH",
            "postal_code": "440409644",
            "telephone_number": "440-488-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 HOUGH AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441034247",
            "telephone_number": "216-231-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOROGHAZI",
        "first_name": "BETHANY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2017-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-023688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0089125",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.