Organization Active NPI

North Bridgeville Dental Clinic LLC

  • Dentist
  • North Ridgeville, OH
National Provider Identifier
1811218845
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
NORTH BRIDGEVILLE DENTAL CLINIC LLC
Practice address
34282 Center Ridge Rd
North Ridgeville, OH 44039
Phone
(440) 327-7950
Fax
(440) 321-1825
NPI assigned
Jun 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Authorized official

Name
Charlyne Jungermann, X
Title
Office Manager
Phone
(440) 327-7950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

34282 Center Ridge Rd
North Ridgeville, OH 44039

Mailing address

34282 Center Ridge Rd
North Ridgeville, OH 44039
Phone (440) 327-7950

Other identifiers 2

IdentifierTypeStateIssuer
0866595MedicaidOH
2934810MedicaidOH

Other names 1

  • North Ridgeville Dental Doing business as

National Provider Directory

National Provider Directory

Locations

34282 Center Ridge Rd
North Ridgeville, OH 44039
Phone (440) 307-1107

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694131200000",
    "number": "1811218845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34282 CENTER RIDGE RD",
            "city": "NORTH RIDGEVILLE",
            "state": "OH",
            "postal_code": "44039",
            "telephone_number": "440-327-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34282 CENTER RIDGE RD",
            "city": "NORTH RIDGEVILLE",
            "state": "OH",
            "postal_code": "44039",
            "telephone_number": "440-327-7950",
            "fax_number": "440-321-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BRIDGEVILLE DENTAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-14",
        "last_updated": "2023-09-08",
        "status": "A",
        "authorized_official_last_name": "JUNGERMANN",
        "authorized_official_first_name": "CHARLYNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "440-327-7950",
        "authorized_official_credential": "X"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0866595",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2934810",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Ridgeville Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Ridgeville Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Ridgeville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.