Cesar Augustin, DDS

Individual provider Active NPI General Practice Dentistry · Poland, OH

NPI 1770629115 · NPPES record last updated Jan 19, 2026

Key facts

NPI
1770629115
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
30-019702 (OH)
Practice address
1320 Boardman Poland Rd Ste C
Poland, OH 44514-1934
Phone
(330) 629-8829
Fax
(330) 629-8630
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160308001479 OH Order and Referring Only - Dentist
Practitioner - Dentist
8022314616

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
DS0490184PAMDDentist
30-019702OHMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS0490184 PA
General Practice Dentistry 1223G0001X 30-019702 OH Yes

Addresses

Primary practice location

1320 Boardman Poland Rd Ste C
Poland, OH 44514-1934

Mailing address

PO Box 545
Youngstown, OH 44501-0545
Phone (330) 518-4861

Other practice location 1

5450 Campbells Run Rd
Pittsburgh, PA 15205-1026
Phone (412) 787-2262 ext. 2

Other practice location 2

5700 Youngstown Warren Rd
Niles, OH 44446-4762
Phone (330) 652-3900 ext. 2

Other providers in Poland, OH

All providers in Poland, OH · General Practice Dentistry in Ohio

Sources for this page

Verify at the official NPI Registry.