Corina Adelaida Custelcean

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30-022087 Issued in OH

Practice address

8376 Old Troy Pike
Huber Heights, OH 45424-1028

Phone

(937) 938-7678

NPI assigned

Apr 3, 2006

Last updated

May 29, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Abc Dental-Robert H Muster Jr DDS, Daniel E Bell DDS, & Corina a Custe

  dba ABC Dental, LLC

  • Dental Clinic/Center
  • Huber Heights, OH
  • NPI 1396901831
  NPD (past)

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401321600000",
    "number": "1861454282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8376 OLD TROY PIKE",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454241028",
            "telephone_number": "937-938-7678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8376 OLD TROY PIKE",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454241028",
            "telephone_number": "937-938-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSTELCEAN",
        "first_name": "CORINA",
        "middle_name": "ADELAIDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2014-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-022087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "9181221",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2603392",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Elleen Crandell, MSN, APRN
• Brandon Crane, DMD
• Robyn Kaye Crow, RPH
• Emmanuel C. Cubol, BSN,RN
• Tawana Cunningham
• Daniel & Max, LLC
• Dasco HME, LLC (Dasco HME)
• Marion Dates, LPN
• Tiffany Davenport
• David Lee Miles (Miles Chiropractic & Injury)

• General Practice Dentistry in Huber Heights, OH
• Providers in Huber Heights, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.