Individual provider Active NPI

Ana E Kromhout, DDS

  • Dentist
  • Fairlawn, OH
National Provider Identifier
1851488555
Registry record updated Aug 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30020164 Issued in OH
Practice address
620 Ridgewood Xing
Fairlawn, OH 44333-3531
Phone
(330) 733-7911
Fax
(330) 376-5214
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30020164 OH Primary

Addresses

Primary practice location

620 Ridgewood Xing
Fairlawn, OH 44333-3531

Mailing address

620 Ridgewood Xing
Suite K
Fairlawn, OH 44333-3531
Phone (330) 733-7911

Other identifiers 1

IdentifierTypeStateIssuer
0995679MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30020164OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250467200000",
    "number": "1851488555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 RIDGEWOOD XING",
            "address_2": "SUITE K",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333531",
            "telephone_number": "330-733-7911",
            "fax_number": "330-376-5214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 RIDGEWOOD XING",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333531",
            "telephone_number": "330-733-7911",
            "fax_number": "330-376-5214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROMHOUT",
        "first_name": "ANA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2009-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30020164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0995679",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2009; 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.