Individual provider Active NPI

Michael David Stern, D.D.S.

  • General Practice Dentistry
  • Willoughby Hills, OH
National Provider Identifier
1871703769
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30014162 Issued in OH
Practice address
34500 Chardon Rd Ste 1
Willoughby Hills, OH 44094-8239
Phone
(440) 975-8444
Fax
(440) 833-4453
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 30.014162 OH
General Practice Dentistry 1223G0001X 30014162 OH Primary

Addresses

Primary practice location

34500 Chardon Rd Ste 1
Willoughby Hills, OH 44094-8239

Mailing address

34500 Chardon Rd Ste 1
Willoughby Hills, OH 44094-8239
Phone (440) 975-8444

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
I20160203002434 OH Order and Referring Only - DentistPractitioner - Dentist 7113221649

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30014162OHMDGeneral Practice Dentistry
30.014162OHMDDurable Medical Equipment & Medical Supplies

Practice roles

OrganizationSpecialtyStatusNew patients
Snoring and Cpap Solutions LLC Durable Medical Equipment & Medical Supplies CurrentSince Dec 18, 2018 Accepting new patients
Michael D. Stern D.D.S., Inc. Past Accepting new patients

Locations

34500 Chardon Rd
Ste 1
Willoughby Hills, OH 44094
Phone (216) 289-8149

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1871703769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34500 CHARDON RD STE 1",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440948239",
            "telephone_number": "440-975-8444",
            "fax_number": "440-975-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34500 CHARDON RD STE 1",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440948239",
            "telephone_number": "440-975-8444",
            "fax_number": "440-833-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OH",
            "license": "30.014162",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30014162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby Hills, OH

Sources for this page

Verify at the official NPI Registry.