Evan David Tetelman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D16334 Issued in OH

Practice address

29001 Cedar Rd
Suite 660
Lyndhurst, OH 44124-4062

Phone

(440) 461-8200

Fax

(440) 461-8343

NPI assigned

Oct 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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 and National Provider Directory roles.

• Streem Resnick Tetelman & Young DDS Inc

  • Dentist
  • Lyndhurst, OH
  • NPI 1144396169
  NPD (past) Authorized official

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1922297480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29001 CEDAR RD",
            "address_2": "SUITE 660",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441244062",
            "telephone_number": "440-461-8200",
            "fax_number": "440-461-8343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29001 CEDAR RD",
            "address_2": "SUITE 660",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441244062",
            "telephone_number": "440-461-8200",
            "fax_number": "440-461-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETELMAN",
        "first_name": "EVAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-22",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "D16334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Synchronized Health and Recovery
• Macey Danielle Szalay
• Linda Taege, LMT
• Thomas Louis Taxman, MD
• Tender Touch of Cleveland
• The Cleveland Clinic Foundation
• The Cleveland Clinic Foundation
• The Cleveland Clinic Foundation
• The Cleveland Clinic Foundation
• Phyllis Thesier

• General Practice Dentistry in Lyndhurst, OH
• Providers in Lyndhurst, 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 Oct 22, 2007; 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.