Peter George Michalos, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

15190 Issued in OH

Practice address

4368 Dressler Rd NW
Canton, OH 44718-2771

Phone

(330) 492-0134

Fax

(330) 492-0410

NPI assigned

Jun 23, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Peter G Michalos DDS Inc

  • Dentist
  • Canton, OH
  • NPI 1598841421
  NPD (past) Authorized official
• Peter G Michalos DDS Inc.

  • General Practice Dentistry
  • Canton, OH
  • NPI 1003023318
  NPD (past) Authorized official

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1932360898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4368 DRESSLER RD NW",
            "address_2": "STE 203",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182776",
            "telephone_number": "330-492-0134",
            "fax_number": "330-492-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4368 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182771",
            "telephone_number": "330-492-0134",
            "fax_number": "330-492-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALOS",
        "first_name": "PETER",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "15190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0324232",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Miceli
• Michael a. Rich, M.D. and Associates, Inc.
• Michael and Brittany Thomas DDS LLC (Thomas Dental Group)
• Michael Tirmonia, DO, Inc
• Micaela Marie Michalk
• Angela M Michel, PT
• Janet Michel, COTA/L
• Benjamin Mickey, LPCC-S
• Jessica Middaugh
• Rachad Deanthony Midgett

• General Practice Dentistry in Canton, OH
• Providers in Canton, 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 Jan 4, 2016; 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.