Individual provider Active NPI

Eugenia Sarris, DDS

  • Dentist
  • Mayfield Heights, OH
National Provider Identifier
1760545677
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30-021349 Issued in OH
Practice address
1300 Som Center Rd
Mayfield Heights, OH 44124-2048
Phone
(440) 684-0900
Fax
(440) 684-0909
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30-021349 OH Primary

Addresses

Primary practice location

1300 Som Center Rd
Mayfield Heights, OH 44124-2048

Mailing address

PO Box 3189
Syracuse, NY 13220-3189
Phone (315) 454-6000

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
I20170127001368 OH Practitioner - Oral Surgery 4880976893 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30-021349OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Medical, Inc. Dentist CurrentSince Jan 1, 2017 Accepting new patients
Mobile Medical Inc Current Accepting new patients
Mobile Medical, Inc. Past Accepting new patients

Locations

1200 Kirts Blvd
Ste 200
Troy, MI 48084
Phone 24852819814031

575 White Pond Dr
Ste A
Akron, OH 44320
Phone (330) 835-1629

3255 Levis Commons Blvd
Perrysburg, OH 43551
Phone (419) 874-0393

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760545677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "315-454-6000",
            "fax_number": "315-454-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 SOM CENTER RD",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441242048",
            "telephone_number": "440-684-0900",
            "fax_number": "440-684-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARRIS",
        "first_name": "EUGENIA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-021349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield Heights, OH

Sources for this page

Verify at the official NPI Registry.