NPIMap

Organization Active NPI

Dental Professionals Cleveland-Nouneh, Inc.

  • Dental Clinic/Center
  • Sandusky, OH
National Provider Identifier
1962687616
Registry record updated May 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
19758 Issued in OH
Legal business name
DENTAL PROFESSIONALS CLEVELAND-NOUNEH, INC.
Practice address
1313 W Bogart Rd
Sandusky, OH 44870-5704
Phone
(419) 627-1255
Fax
(419) 627-0422
NPI assigned
Dec 31, 2007
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONAL CLEVELAND-NOUNEH, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 13, 2009

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

Authorized official

Name
Diane L Ulichney
Title
Credentialing Manager
Phone
(440) 345-9068

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 19758 OH Primary

Addresses

Primary practice location

1313 W Bogart Rd
Sandusky, OH 44870-5704

Mailing address

6315 Pearl Rd Ste 201
Parma Heights, OH 44130-3074
Phone (440) 345-9068

Other identifiers 1

IdentifierTypeStateIssuer
2497454MedicaidOH

Other names 1

  • bright now dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals Cleveland-Nouneh Inc11 organizations share this tax ID, including this one
Part of
Dental Professionals Cleveland-Nouneh Inc

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242172800000",
    "number": "1962687616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6315 PEARL RD STE 201",
            "city": "PARMA HEIGHTS",
            "state": "OH",
            "postal_code": "441303074",
            "telephone_number": "440-345-9068",
            "fax_number": "440-842-4612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 W BOGART RD",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448705704",
            "telephone_number": "419-627-1255",
            "fax_number": "419-627-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS CLEVELAND-NOUNEH, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONAL CLEVELAND-NOUNEH, INC.",
        "enumeration_date": "2007-12-31",
        "last_updated": "2009-05-13",
        "status": "A",
        "authorized_official_last_name": "ULICHNEY",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "440-345-9068"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OH",
            "license": "19758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2497454",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "bright now dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sandusky, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.