Gerald H. Kassoy DDS,Ms, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

14900 Issued in OH

Legal business name

GERALD H. KASSOY DDS,MS, LLC

Practice address

1418 Brice Rd
Reynoldsburg, OH 43068-2397

Phone

(614) 575-2225

Fax

(614) 575-2252

NPI assigned

Sep 30, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Gerald Howard Kassoy, DDS,MS

Title

Dr. / Owner

Phone

(614) 575-2225

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285804800000",
    "number": "1831408475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 BRICE RD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430682397",
            "telephone_number": "614-575-2225",
            "fax_number": "614-575-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 BRICE RD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430682397",
            "telephone_number": "614-575-2225",
            "fax_number": "614-575-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERALD H. KASSOY DDS,MS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-30",
        "last_updated": "2010-09-30",
        "status": "A",
        "authorized_official_last_name": "KASSOY",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "DR. / OWNER",
        "authorized_official_telephone_number": "614-575-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS,MS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "14900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2703837",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Reynoldsburg, OH
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• Pediatric Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; 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.