Bradley Warren Hylan DMD Fairview LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BRADLEY WARREN HYLAN DMD FAIRVIEW LLC

Practice address

22245 Lorain Rd
Fairview Park, OH 44126-3315

Phone

(440) 644-8100

NPI assigned

Aug 29, 2022

Last updated

Aug 29, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alyssa Gullatta

Title

Manager

Phone

(330) 962-6363

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bradley Warren Hylan, D.M.D

  • General Practice Dentistry
  • Cleveland, OH
  • NPI 1740486927
  NPD
• Maryou Ibrahim

  • General Practice Dentistry
  • Fairview Park, OH
  • NPI 1336039387
  NPD

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661731200000",
    "number": "1861112138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22245 LORAIN RD",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441263315",
            "telephone_number": "440-644-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22245 LORAIN RD",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441263315",
            "telephone_number": "440-644-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY WARREN HYLAN DMD FAIRVIEW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A",
        "authorized_official_last_name": "GULLATTA",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "330-962-6363"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ravisankar R Bolla, MD
• David Gillard Bostwick Sr., LISW, LCDCIII, SAP
• Siobhan Bowden
• Jeffrey Bowersox, LSW
• Mark C Boyle, OTR/L
• Kathleen B Bremer, MS, PCC-S
• David Brockett, LPC
• Laura Kathleen Broughton, MS, CCC-SLP
• Sheryl Lea Buckley, M.D.
• Kelly Calta, PHARMD., CGP

• Dental Clinic/Center in Fairview Park, OH
• Providers in Fairview Park, OH by specialty
• Dental Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.