Individual provider Active NPI

Philip Brian Smaldino, DDS

  • Dentist
  • Poland, OH
National Provider Identifier
1770534679
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18108 Issued in OH
Practice address
263 W McKinley Way
Poland, OH 44514
Phone
(330) 757-2412
Fax
(330) 757-2503
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 18108 OH Primary

Addresses

Primary practice location

263 W McKinley Way
Poland, OH 44514

Mailing address

263 W McKinley Way
Poland, OH 44514
Phone (330) 757-2412

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
I20150331001291 OH Order and Referring Only - DentistPractitioner - Dentist 1658698667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18108OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359936000000",
    "number": "1770534679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 W MCKINLEY WAY",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "44514",
            "telephone_number": "330-757-2412",
            "fax_number": "330-757-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 W MCKINLEY WAY",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "44514",
            "telephone_number": "330-757-2412",
            "fax_number": "330-757-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALDINO",
        "first_name": "PHILIP",
        "middle_name": "BRIAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2013-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "18108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poland, OH

Sources for this page

Verify at the official NPI Registry.