DENTAL EXPRESS BOARDMAN, TED A SCHUSTER DDS LLC (NPI# 1962730549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962730549 |
| Entity Type | Organization |
| Organization Name | DENTAL EXPRESS BOARDMAN, TED A SCHUSTER DDS LLC |
| Practice Address |
6540 South Ave Boardman OH 44512-3651 |
| Practice Telephone | 3305333400 |
| Mailing Telephone | 3305333400 |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2010-07-20 |
| Authorized Official Name | AMY R MAUERMAN (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Telephone | 3305333400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 30022311 | OH | Dental Providers |
| N | 122300000X | Dentist | 30015046 | OH | Dental Providers |
| N | 122300000X | Dentist | 30-012873 | OH | Dental Providers |
| N | 122300000X | Dentist | 30-01955 | OH | Dental Providers |
| N | 122300000X | Dentist | 30-022882 | OH | Dental Providers |
| N | 122300000X | Dentist | 30-023087 | OH | Dental Providers |
| Y | 122300000X | Dentist | 30020654 | OH | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0296166 | 05 | |
| OH | 2994578 | 05 | |
| OH | 2966992 | 05 |
| Street Address |
6540 SOUTH AVE |
| City | BOARDMAN |
| State | OH |
| Zip Code | 44512-3651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225001241 | James M Gentile | Dentist | 6540 South Ave, Suite B, Boardman, OH 44512-3651 | 2006-02-09 |
| 1497248736 | Hanjun Guan | Dentist | 6540 South Ave, Boardman, OH 44512-3651 | 2018-06-12 |
| 1588006902 | Samer Adnan Faraj | Dentist | 6540 South Ave, Boardman, OH 44512-3651 | 2013-07-26 |
| 1457656621 | Professional Dental Alliance | Dentist | 6540 South Ave, Boardman, OH 44512-3651 | 2011-01-20 |
| 1194029736 | Andrew S Matta Dmd Boardman LLC | Dentist | 6540 South Ave, Boardman, OH 44512-3651 | 2010-12-22 |
| 1205908183 | Kingsley E Baldwin IIi | Dentist | 6540 South Ave, Boardman, OH 44512-3651 | 2006-11-15 |
| 1154330694 | Eugene Schlank | Dentist | 6540 South Ave, Boardman, OH 44512-3651 | 2006-08-05 |
| 1477597607 | Lawrence R Liguore | Dentist | 6540 South Ave, Boardman, OH 44512-3651 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285248740 | Kimberly Vrabel | Counselor | 725 Boardman Canfield Road Road Unit 1 and Unit 2, Boardman, OH 44512 | 2020-09-02 |
| 1043830144 | Steffi Lorraine D'souza | Student in an Organized Health Care Education/Training Program | 8423 Market Street Suite 101 St. Elizabeth Boardman Hos, Boardman, OH 44512 | 2020-04-20 |
| 1427677830 | Shivani Sharma | Family Medicine | 8423 Market Street Suite 101, St Elizabeth Boardman Hospital, Boardman, OH 44512 | 2020-04-15 |
| 1417587825 | Ronny Zetts | Pharmacist | 308 Boardman-canfield Rd, Boardman, OH 44512 | 2020-01-24 |
| 1285105080 | Andrew Dawson | Nurse Practitioner | 883 Boardman Canfield Rd Ste 105, Youngstown, OH 44512 | 2018-12-06 |
| 1700374949 | Adam Leid | Student in an Organized Health Care Education/Training Program | St Elizabeth Boardman Hospital - Medical Education Dept, 8401 Market Street, Boardman, OH 44512 | 2018-04-24 |
| 1528574910 | Herman Frank IIi | Licensed Practical Nurse | 920 Boardman Canfield Road, Boardman, OH 44512 | 2017-12-20 |
| 1730601980 | Stephanie Ann Mathews | Nurse Practitioner | 7600 Southern Blvd #1, Boardman, OH 44512 | 2017-07-10 |
| 1417485079 | Telka Ghobadi | Family Medicine | 8423 Market St., Suite 101, Boardman, OH 44512 | 2017-05-26 |
| 1356797534 | Haroon Hussain Syed | Student in an Organized Health Care Education/Training Program | 8423 Market Street, St. Elizabeth Boardman Hospital, Boardman, OH 44512 | 2016-05-06 |
| Find all providers in zip 44512 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467646240 | Robert Carl Johnson Jr. | Dentist | 7260 West Blvd, Bldg. G, Boardman, OH 44512-7334 | 2007-09-05 |
| 1033277546 | Johanna Santos Nogay | Dentist | 930 Boardman Poland Rd, Allcare Dental Rt 224, Boardman, OH 44512 | 2006-12-05 |
| 1013002989 | Phil J Snyder | Dentist | 250 Debartolo Place, Suite 1610, Boardman, OH 44512 | 2006-10-04 |
| 1518068964 | John Douglas Beal | Dentist | 810 Boardman Canfield Rd, Boardman, OH 44512 | 2006-09-26 |
| 1811093545 | David A Wyatt, Dds, Lls | Dentist | 99 Debartolo Pl, Boardman, OH 44512 | 2006-09-16 |
| 1285665869 | John Vincent Craig IIi | Dentist | 7240 Glenwood Ave, Boardman, OH 44512 | 2006-07-05 |
| 1356395768 | Donald A Dechellis Dds Inc | Dentist | 60 Marwood Circle, Boardman, OH 44512 | 2006-05-20 |
| 1700835840 | Edwina L Burke | Dentist | 755 Boardman-canfield Road Unit L2, Boardman, OH 44512 | 2006-05-08 |
| 1235109604 | Dr. Dellagatta & Associates (southern Park), Inc. | Dentist | 930 Boardman-poland Road, Boardman, OH 44512 | 2006-01-26 |
| 1962801084 | Rose Greyslak | Dentist | 300 Tatone, Boardman, OR 97818-9999 | 2014-08-14 |
| Find all providers in BOARDMAN | ||||
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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.