Individual provider Active NPI

Mark Stewart Perlman, DDS

  • Dentist
  • Brookfield, OH
National Provider Identifier
1972534568
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
16515 Issued in OH
Practice address
7124 Brookwood Dr
Brookfield, OH 44403
Phone
(330) 448-2571
NPI assigned
Jul 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 16515 OH Primary

Addresses

Primary practice location

7124 Brookwood Dr
Brookfield, OH 44403

Mailing address

7124 Brookwood Dr
Brookfield, OH 44403
Phone (330) 448-2571

Other identifiers 1

IdentifierTypeStateIssuer
0483132MedicaidOH

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
I20150422001274 OH Practitioner - Dentist 8628396629 Practice locations: Brookfield, OH

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16515OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972534568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7124 BROOKWOOD DR",
            "city": "BROOKFIELD",
            "state": "OH",
            "postal_code": "44403",
            "telephone_number": "330-448-2571",
            "fax_number": "330-448-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7124 BROOKWOOD DR",
            "city": "BROOKFIELD",
            "state": "OH",
            "postal_code": "44403",
            "telephone_number": "330-448-2571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERLMAN",
        "first_name": "MARK",
        "middle_name": "STEWART",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "16515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0483132",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, OH

Sources for this page

Verify at the official NPI Registry.