Active NPI
Maxemilian Nascimento, DDS
- Dentist
- Cleveland, OH
National Provider Identifier
1871228262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30.026864
- Practice address
- 9601 Chester Ave
Cleveland, OH 44106-1666 - Phone
- (216) 368-3200
- NPI assigned
- Jul 19, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30.026864 | OH | Primary |
Addresses
Primary practice location
9601 Chester Ave
Cleveland, OH 44106-1666
Mailing address
75 Public SQ Apt 509
Cleveland, OH 44113-2002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230508002600 | IN | Order and Referring Only - Dentist | 4385009745 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.026864 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658188800000",
"number": "1871228262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 PUBLIC SQ APT 509",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441132002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9601 CHESTER AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441061666",
"telephone_number": "216-368-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NASCIMENTO",
"first_name": "MAXEMILIAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-19",
"last_updated": "2022-07-19",
"certification_date": "2022-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30.026864",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.