EAST COLUMBUS PERIODONTICS LLC (NPI# 1922610203) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922610203 |
| Entity Type | Organization |
| Organization Name | EAST COLUMBUS PERIODONTICS LLC |
| Practice Address |
5180 E Main St Columbus OH 43213-2436 |
| Mailing Address |
5152 Blazer Pkwy Ste 100 Dublin OH 43017-7323 |
| Practice Telephone | 6148642561 |
| Mailing Telephone | 6148898222 |
| Mailing Fax Number | 6148896067 |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2020-08-19 |
| Authorized Official Name | JASON C STONER (MEMBER) |
| Authorized Official Telephone | 6148898222 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | LICENSE | 30020951 | 01 |
| Street Address |
5180 E MAIN ST |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43213-2436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972531051 | Susan C Zacatelco | Optometrist | 5180 E Main St, Columbus, OH 43213 | 2006-06-29 |
| 1861053647 | Nicholas M Kerns, Dds, Ms, LLC | Dentist | 5180 E Main St, Columbus, OH 43213-2436 | 2019-06-24 |
| 1942681176 | Scott Hanes | Optometrist | 5180 E Main St, Columbus, OH 43213-2436 | 2015-06-12 |
| 1245469154 | Jaclyn Marie Paskiet | Optometrist | 5180 E Main St, Suite F, Columbus, OH 43213-2436 | 2009-07-13 |
| 1336303155 | Darrell D Dye | Optometrist | 5180 E Main St, Suite F, Columbus, OH 43213-2436 | 2008-07-10 |
| 1710198726 | Sara Megan Fowler | Dentist | 5180 E Main St, Columbus, OH 43213-2436 | 2007-05-24 |
| 1891904843 | Alven L. Herstig, Dds, Inc. | Dentist | 5180 E Main St, Suite B, Columbus, OH 43213-2436 | 2007-05-22 |
| 1427267319 | Douglas Lin | Dentist | 5180 E Main St, Columbus, OH 43213-2436 | 2007-05-21 |
| 1174649438 | Alan R. Levy | Dentist | 5180 E Main St, Suite A, Columbus, OH 43213-2436 | 2007-03-21 |
| 1346373453 | Michael S Berk Od Inc | Optometrist | 5180 E Main St, Suite F, Columbus, OH 43213-2436 | 2007-03-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952917973 | Complete Care for Women | Obstetrics & Gynecology | 99 North Brice Rd, Suite 320, Columbus, OH 43213 | 2020-09-16 |
| 1255963708 | Icare Health & Wellness Medical Center, LLC | Counselor | 3242 E Main St, 2nd Floor, Columbus, OH 43213 | 2020-02-12 |
| 1588133011 | Robert Acheampong-imbeah | Case Manager/Care Coordinator | 3616 Eastwood Park, Whitehall, OH 43213 | 2018-11-14 |
| 1174017248 | Faatimah Sabir | Case Manager/Care Coordinator | 3616 East Main Street, Whitehall, OH 43213 | 2018-06-21 |
| 1639663123 | Reachcare Pharmacy Services LLC | Pharmacy | 4513 E Main St, Columbus, OH 43213 | 2018-06-18 |
| 1245729516 | Dominique Oswalt | Case Manager/Care Coordinator | 4111 Elbern Ave, Whitehall, OH 43213 | 2018-05-02 |
| 1326540865 | Jmkennedy LLC Magnum Np | Nursing Care | 6365 Plankton Dr, Columbus, OH 43213 | 2018-03-01 |
| 1477051647 | Inner Health Chiropractic North, LLC | Chiropractor | Inner Health Chiropractic, 3321 East Broad Street, Columbus, OH 43213 | 2018-01-23 |
| 1902319213 | Mary H Taylor | Massage Therapist | 6100 E. Main St., Suite 110, Columbus, OH 43213 | 2017-11-08 |
| 1407384548 | Lashaunta R Davidson | Licensed Practical Nurse | 4040 E. Broad Street, Whitehall, OH 43213 | 2017-06-02 |
| Find all providers in zip 43213 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114524477 | Katherine E. Ferry | Dentist | 4303 E Windsor Ln, Columbus, IN 47201-4022 | 2020-10-08 |
| 1194334136 | Nerea Robles-leyzaola | Dentist | 154 E Oakland Ave, Columbus, OH 43201-1209 | 2020-07-27 |
| 1639724438 | Vinayak Joshi | Dentist | 4103 Postle Hall, 305 West 12th Avenue, Columbus, OH 43210-1267 | 2019-08-08 |
| 1972098432 | Ying Wang | Dentist | 305 W 12th Ave Fl 2, Columbus, OH 43210-1267 | 2018-06-27 |
| 1275932006 | Javier Sanz Moliner | Dentist | 103 Mansfield Rd E, Columbus, NJ 08022-2108 | 2014-08-18 |
| 1417290701 | Pin-chuang Lai | Dentist | 305 W 12th Ave Rm 2015, Columbus, OH 43210-1267 | 2013-04-04 |
| 1962614610 | Bruce A Boretsky Dmd, LLC | Dentist | 7310 N Lake Dr, Suite C, Columbus, GA 31909-2787 | 2007-05-04 |
| 1134341407 | Nichols Periodontics LLC | Dentist | 2401 5th Street North, Suite 2, Columbus, MS 39705 | 2007-05-03 |
| 1417022427 | Gregory Ellis Phillips | Dentist | 3180 Middle Dr, Columbus, IN 47203-2298 | 2006-11-22 |
| 1992890107 | Robert Aurelio Vazquez | Dentist | 3908 Rosemont Dr, Columbus, GA 31904-5626 | 2006-10-04 |
| Find all providers in COLUMBUS | ||||
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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.