Individual provider Active NPI

Brandon James Kroffke, DDS

  • General Practice Dentistry
  • Strongsville, OH
National Provider Identifier
1770848608
Registry record updated Jul 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-023744 Issued in OH
Practice address
15207 Pearl Rd
Strongsville, OH 44136-5020
Phone
(440) 572-4840
Fax
(440) 572-3814
NPI assigned
Jul 6, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30-023744 OH Primary

Addresses

Primary practice location

15207 Pearl Rd
Strongsville, OH 44136-5020

Mailing address

15207 Pearl Rd
Strongsville, OH 44136-5020
Phone (440) 572-4840

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
I20151208001931 OH Order and Referring Only - DentistPractitioner - Dentist 8628378007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30-023744OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
John a Hudec Strongsville Dental Associates Inc General Practice Past Accepting new patients

Organizations & group practices 1

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": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341532800000",
    "number": "1770848608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15207 PEARL RD",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441365020",
            "telephone_number": "440-572-4840",
            "fax_number": "440-572-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15207 PEARL RD",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441365020",
            "telephone_number": "440-572-4840",
            "fax_number": "440-572-3814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROFFKE",
        "first_name": "BRANDON",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-06",
        "last_updated": "2012-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-023744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Strongsville, OH

Sources for this page

Verify at the official NPI Registry.