Organization Active NPI

Center for Advanced Periodontal & Implant Care, Inc.

  • Periodontics
  • Canton, OH
National Provider Identifier
1750782298
Registry record updated Sep 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
CENTER FOR ADVANCED PERIODONTAL & IMPLANT CARE, INC.
Practice address
4410 Executive Cir NW
Canton, OH 44718-2983
Phone
(330) 494-7004
Fax
(330) 494-7071
NPI assigned
Sep 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2014

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

Authorized official

Name
Dr. Constantin Farah, DDS, MSDNPI 1477517852
Title
Ceo
Phone
(330) 494-7004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X Primary

Addresses

Primary practice location

4410 Executive Cir NW
Canton, OH 44718-2983

Mailing address

4410 Executive Cir NW
Canton, OH 44718-2983
Phone (330) 494-7004

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1410739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410739200000",
    "number": "1750782298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 EXECUTIVE CIR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182983",
            "telephone_number": "330-494-7004",
            "fax_number": "330-494-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 EXECUTIVE CIR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182983",
            "telephone_number": "330-494-7004",
            "fax_number": "330-494-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR ADVANCED PERIODONTAL & IMPLANT CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-15",
        "last_updated": "2014-09-15",
        "status": "A",
        "authorized_official_last_name": "FARAH",
        "authorized_official_first_name": "CONSTANTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-494-7004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MSD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; 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.