Individual provider Active NPI

William Franklin Lavigna, DDS

  • Dentist
  • Cleveland, OH
National Provider Identifier
1871584870
Registry record updated Sep 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14847 Issued in OH
Practice address
11201 Shaker Blvd
Cleveland, OH 44104-3869
Phone
(216) 368-7238
Fax
(216) 791-8322
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14847 OH Primary

Addresses

Primary practice location

11201 Shaker Blvd
Cleveland, OH 44104-3869

Mailing address

11201 Shaker Blvd
Cleveland, OH 44104-3833
Phone (216) 368-7238

Other identifiers 1

IdentifierTypeStateIssuer
0374492MedicaidOH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150702002104 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0345552394

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14847OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189987200000",
    "number": "1871584870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11201 SHAKER BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441043833",
            "telephone_number": "216-368-7238",
            "fax_number": "216-791-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 SHAKER BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441043869",
            "telephone_number": "216-368-7238",
            "fax_number": "216-791-8322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVIGNA",
        "first_name": "WILLIAM",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2007-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "14847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0374492",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.