Jeremy Michael Capetillo, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

30.24705 Issued in OH

Practice address

8740 E Market St Ste 1
Warren, OH 44484

Phone

(330) 856-9989

NPI assigned

May 10, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1922454800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8740 E MARKET ST STE 1",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842324",
            "telephone_number": "330-856-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8740 E MARKET ST STE 1",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "44484",
            "telephone_number": "330-856-9989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 W 12th Ave",
            "address_2": "3059 Postle Hall",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101267",
            "country_code": "US",
            "telephone_number": "614-292-3596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAPETILLO",
        "first_name": "JEREMY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-10",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.24705",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "OH",
            "license": "30.24705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel Cameron, CDCA
• Robert Douglas Cameron, DPT
• Samantha Camlin
• James Campbell, Jr, CDCA
• Jacob Rangel Campos, CDCA
• Cara Kalogerou DPM, Inc.
• Ken A Carano Jr., R.N.
• Victor Cardarelli, COTA/L
• Cardiac Management Inc
• Nicholas Cardinal, DO

• Endodontics in Warren, OH
• Providers in Warren, OH by specialty
• Endodontics in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; 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.