DR. JEREMY MICHAEL CAPETILLO (NPI# 1922454800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922454800 |
| Entity Type | Individual |
| Full Name | DR. JEREMY MICHAEL CAPETILLO |
| Credential | D.D.S. |
| Practice Address |
8740 E Market St Ste 1 Warren OH 44484 |
| Mailing Address |
8740 E Market St Ste 1 Warren OH 44484-2324 |
| Practice Telephone | 3308569989 |
| Mailing Telephone | 3308569989 |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2018-08-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 30.24705 | OH | Dental Providers |
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
30.24705 | OH | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 305 W 12th Ave, 3059 Postle Hall, Columbus, OH 432101267 | 6142923596 |
| Street Address |
8740 E MARKET ST STE 1 |
| City | WARREN |
| State | OH |
| Zip Code | 44484 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205446283 | Jessica Toot | Behavior Technician | Oakwood Counseling Center LLC, 1704 North Road Se, Warren, OH 44484 | 2020-08-05 |
| 1558857060 | Quantina Louise Thomas | Home Health | 1548oak Knoll Se, Warren, OH 44484 | 2018-07-09 |
| 1033609706 | Justin A Houy | Massage Therapist | 8345 E. Market St. Suite C, The Chiropractic and Functional Neurology Center, Warren, OH 44484 | 2018-05-17 |
| 1679091359 | Ester Mae Butler | Nurse's Aide | 2228 Draper Avenue Se, Warren, OH 44484 | 2017-09-01 |
| 1477070811 | Amanda Lynn Heberling | Occupational Therapy Assistant | 8128 Kenyon Dr., Warren, OH 44484 | 2017-08-26 |
| 1790213650 | Joyce A Mechling | Licensed Practical Nurse | 2737 Youngstown Rd., Warren, OH 44484 | 2017-05-23 |
| 1598206898 | Stan Catullo | Substance Abuse Rehabilitation Facility | 2737 Youngstown Warren Road Se, Warren, OH 44484 | 2017-03-20 |
| 1679014054 | Pamela M Lang | Pharmacist | 1977 Niles Rd S.e., Genoa A Qol Healthcare Company, Warren, OH 44484 | 2017-03-17 |
| 1215311865 | Jessica Dawn Harris | Physical Therapy Assistant | 1926 Ridge Avenue, Warren, OH 44484 | 2015-07-14 |
| 1326429432 | Keyonna Ellis- Slaughter | Technician | 728 Oak Knoll Ave Se, Warren, OH 44484 | 2015-06-15 |
| Find all providers in zip 44484 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518401108 | Lev, Berberich, Stabile, Direnzo Ltd | Dentist | 8740 E Market St, Warren, OH 44484-2324 | 2016-12-15 |
| 1871677567 | Jeffrey D Spiegle | Dentist | 8023 E Market St, Warren, OH 44484-2229 | 2006-10-25 |
| 1427598598 | Amruta Mahajan | Dentist | 2425 E 12 Mile Rd, Warren, MI 48092-5667 | 2017-03-08 |
| 1497969844 | Michigan Endodontics PC | Dentist | 11300 E 13 Mile Rd, Warren, MI 48093 | 2007-05-09 |
| 1053530840 | Wayne I. Levine | Dentist | 10 Mountain Blvd, Warren, NJ 07059-2639 | 2007-04-24 |
| 1518092600 | Lawrence C Walsh | Dentist | 11300 E 13 Mile Rd, Warren, MI 48093 | 2007-02-22 |
| 1962537050 | Steven E Fegan | Dentist | 11300 E 13 Mile Rd, Warren, MI 48093 | 2007-02-22 |
| 1619002706 | Derik Peter Deconinck | Dentist | 11300 E 13 Mile Rd, Warren, MI 48093 | 2007-02-22 |
| 1124163738 | A Timothy Deconinck | Dentist | 11300 E 13 Mile Rd, Warren, MI 48093 | 2007-02-21 |
| 1578675732 | Raymond Lev | Dentist | 321 Niles Cortland Rd Ne, Warren, OH 44484 | 2006-08-31 |
| Find all providers in WARREN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.