WESTERN RESERVE PERIODONTICS, INC (NPI# 1699964759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699964759 |
| Entity Type | Organization |
| Organization Name | WESTERN RESERVE PERIODONTICS, INC |
| Practice Address |
3609 Park East Dr #411 Beachwood OH 44122-4331 |
| Practice Telephone | 2164647338 |
| Mailing Telephone | 2164647338 |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2007-10-15 |
| Authorized Official Name | DR. FREDRICK A ROSENBERG (SECRETARY/TREASURER) |
| Authorized Official Telephone | 2164648985 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers |
| Street Address |
3609 PARK EAST DR #411 |
| City | BEACHWOOD |
| State | OH |
| Zip Code | 44122-4331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477550028 | Tonya S. Heyman | Specialist | 3609 Park East Dr, Ste 210n, Beachwood, OH 44122-4309 | 2005-06-28 |
| 1023471059 | Cleveland Center for Comprehensive Dentistry | Dentist | 3609 Park East Dr, Suite 404, Beachwood, OH 44122-4331 | 2016-03-29 |
| 1760886154 | Margaret Lakin | Nurse Practitioner | 3609 Park East Dr, Suite 206, Beachwood, OH 44122-4331 | 2014-10-15 |
| 1043547680 | Thomas Anthony Difranco | Psychologist | 3609 Park East Dr, Suite 518,north, Beachwood, OH 44122-4331 | 2009-11-03 |
| 1972734481 | Spectrum Diagnostic Imaging of Ohio LLC | Radiology | 3609 Park East Dr, Suite 101, Beachwood, OH 44122-4331 | 2009-07-31 |
| 1346496585 | Regional Diagnostics, LLC | Radiology | 3609 Park East Dr, Suite 101, Beachwood, OH 44122-4331 | 2008-08-07 |
| 1548435464 | Shanail Renee Lampkin | Internal Medicine | 3609 Park East Dr, Beachwood, OH 44122-4331 | 2008-04-23 |
| 1871774976 | Nora Elizabeth Colburn | Internal Medicine | 3609 Park East Dr, Suite 207, Beachwood, OH 44122-4331 | 2007-11-16 |
| 1336360171 | Drs. Esposito, Ostrowski, & Whitmyer, LLC | Dentist | 3609 Park East Dr, Suite 501 North, Beachwood, OH 44122-4331 | 2007-05-01 |
| 1720205677 | Harold Mars, Md, Inc. | Psychiatry & Neurology | 3609 Park East Dr, Suite 517, Beachwood, OH 44122-4331 | 2007-04-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083174 | Sophia Denise Moncrieffe-jordan | Nurse Practitioner | 23511 Chargin Blvd, Apt. E312, Beachwood, OH 44122 | 2020-11-03 |
| 1447864400 | Resilient Bodies LLC | Massage Therapist | 24300 Chagrin Blvd #312, Beachwood, OH 44122 | 2020-09-06 |
| 1215576087 | Hni Emergency Services of Ohio, LLC | Nurse Practitioner | 22501 Chagrin Blvd, Beachwood, OH 44122 | 2019-12-27 |
| 1013555648 | Barbara L Ekelman Phd Inc | Psychologist | 24100 Chagrin Blvd, Suite 385, Beachwood, OH 44122 | 2019-12-13 |
| 1417599770 | Janise Moore | Technician | 19600 Gladstone Rd, Warrensville Hts, OH 44122 | 2019-10-08 |
| 1598312704 | Nizar Andria | Student in an Organized Health Care Education/Training Program | Cedar Rd 27050, Apartment 515, Beachwood, OH 44122 | 2019-08-22 |
| 1437703998 | Malinda Ann Davis | Social Worker | 20600 Chagrin Blvd Suite 320, Shaker Heights, OH 44122 | 2019-08-01 |
| 1891265864 | Karlan Champagne | Case Management | 23215 Commerence Park, 306, Beachwood, OH 44122 | 2018-12-03 |
| 1952896565 | Donna Pinkney | Counselor | 20550 University Blvd Apt 206, Shaker Hts, OH 44122 | 2018-06-26 |
| 1255825857 | Elizabeth Anne Donathan | Registered Nurse | 4100 Warrensville Center Rd Ste 101, Warrensville Heights, OH 44122 | 2018-06-18 |
| Find all providers in zip 44122 | ||||
| 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 |
|---|---|---|---|---|
| 1790104891 | Ernest Erian | Dentist | 27030 Cedar Road, Apt 305-2, Beachwood, OH 44122 | 2014-04-16 |
| 1093157018 | Abdelazeem Hazem Desoky | Dentist | 27060 Cedar Rd, 806, Beachwood, OH 44122-8103 | 2013-07-18 |
| 1790015618 | Sasha Ross | Dentist | 3609 Park East Dr Ste 411, Beachwood, OH 44122-4309 | 2009-12-29 |
| 1043462849 | Marcus Castro | Dentist | 3690 Orange Pl Ste 395, Beachwood, OH 44122-4465 | 2008-10-13 |
| 1235201823 | Barry A Sogoloff | Dentist | 23250 Chagrin Boulevard, Commerce Park Square Building 5 Suite 205, Beachwood, OH 44122 | 2006-11-15 |
| 1609956341 | Charlene B Krejci | Dentist | 3609 Park East Dr, 411, Beachwood, OH 44122-4309 | 2006-10-17 |
| 1730269465 | Stuart B Sears | Dentist | 3609 Park East Dr, 411, Beachwood, OH 44122-4309 | 2006-10-17 |
| 1023198751 | Fredrick A Rosenberg | Dentist | 3609 Park East Dr, 411, Beachwood, OH 44122-4309 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194334136 | Nerea Robles-leyzaola | Dentist | 154 E Oakland Ave, Columbus, OH 43201-1209 | 2020-07-27 |
| 1801419866 | Morgan & Lemke Dds Ms Inc | Dentist | 6505 Rockside Rd Ste 310, Independence, OH 44131-2386 | 2020-05-26 |
| 1639724438 | Vinayak Joshi | Dentist | 4103 Postle Hall, 305 West 12th Avenue, Columbus, OH 43210-1267 | 2019-08-08 |
| 1306408687 | Newark Periodontics LLC | Dentist | 843 N 21st St Ste 102a, Newark, OH 43055-7274 | 2019-07-08 |
| 1386201101 | Fred O Sakamoto Dds, Inc | Dentist | 7334 E Broad St Ste B, Blacklick, OH 43004-9239 | 2019-05-28 |
| 1972098432 | Ying Wang | Dentist | 305 W 12th Ave Fl 2, Columbus, OH 43210-1267 | 2018-06-27 |
| 1982128773 | Periodontics of Toledo | Dentist | 223 W. Crawford, Findlay, OH 45840 | 2017-08-02 |
| 1831545854 | Griselle Ortiz-ramsey Dmd and Associates | Dentist | 1569 Mckaig Ave, Troy, OH 45373-4904 | 2016-05-09 |
| 1225406622 | Alexandra Seal | Dentist | 4646 Nantuckett Dr Ste A, Toledo, OH 43623-3194 | 2015-09-02 |
| 1437551603 | Peter Nader Nessim Amin | Dentist | 7081 Pearl Rd, Middleburg Heights, OH 44130-4940 | 2014-09-19 |
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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.