Elliott Daniel Detrich, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

30.027603 Issued in OH

Practice address

7528 Pearl Rd
Middleburg Heights, OH 44130-6430

Phone

(440) 888-6783

NPI assigned

Apr 17, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1831944529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 GRANDVIEW AVE",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441063119",
            "telephone_number": "419-989-7715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7528 PEARL RD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441306430",
            "telephone_number": "440-888-6783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETRICH",
        "first_name": "ELLIOTT",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.027603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Defelice
• Debra Defranco, FNP-C
• Melissa Dennis
• Dental Services of Ohio, James G. Turk, DDS,& Denean R. Carr, DDS, Inc
• Dipali A Desai, MD
• Genaveive Marie Dever
• Julie Elizabeth Diegelmann, PA-C
• Jennifer Lynne Digiandomenico, LPCC
• Linda M Dilisi, MD
• Lonnie Dittrick

• Dentist in Middleburg Heights, OH
• Providers in Middleburg Heights, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.