Individual provider Active NPI

Norman Ernest Facter, DDS

  • General Practice Dentistry
  • Solon, OH
National Provider Identifier
1770633794
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.016935 Issued in OH
Practice address
5178 Crofton Ave
Solon, OH 44139-1288
Phone
(440) 349-2848
Fax
(440) 349-0848
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 16935 OH
General Practice Dentistry 1223G0001X 30.016935 OH Primary

Addresses

Primary practice location

5178 Crofton Ave
Solon, OH 44139-1288

Mailing address

PO Box 316
Williamsville, NY 14231
Phone (716) 204-5838

Other identifiers 1

IdentifierTypeStateIssuer
0513313MedicaidOH

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
I20241112002626 OH Order and Referring Only - DentistPractitioner - Dentist 6709310881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16935OHMDDentist
30.016935OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1770633794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 316",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "14231",
            "telephone_number": "716-204-5838",
            "fax_number": "716-632-2963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5178 CROFTON AVE",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441391288",
            "telephone_number": "440-349-2848",
            "fax_number": "440-349-0848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FACTER",
        "first_name": "NORMAN",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "16935",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.016935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0513313",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Solon, OH

Sources for this page

Verify at the official NPI Registry.