Facial & Aesthetic Plastic Surgery Center, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

FACIAL & AESTHETIC PLASTIC SURGERY CENTER, LLC

Practice address

6505 Market St
Suite A103B
Boardman, OH 44512-3457

Phone

(330) 758-0191

Fax

(330) 726-3577

NPI assigned

May 24, 2007

Organization subpart

No

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

Authorized official

Name

Richard D Gentile, M.D.

Title

Medical Director

Phone

(330) 758-0191

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821209909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6505 MARKET ST",
            "address_2": "SUITE A103B",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445123457",
            "telephone_number": "330-758-0191",
            "fax_number": "330-726-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 MARKET ST",
            "address_2": "SUITE A103B",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445123457",
            "telephone_number": "330-758-0191",
            "fax_number": "330-726-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACIAL & AESTHETIC PLASTIC SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GENTILE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "330-758-0191",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Lynn Evans, RN
• Kennedy Evans
• Michelle L Evans, CNP
• Eyecare for the Valley LLC
• Tiffany Marie Fabian, CNM
• Samer Adnan Faraj, BDS
• Charles Farrell
• Georgene Farris
• Michael V Farris, P.T.
• Ronald D Fasano, MSED, LPC

• Clinic/Center in Boardman, OH
• Providers in Boardman, OH by specialty
• Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.