DR. JOHN HERBERT GERSTENMAIER JR. DDS
NPI 1669454302
Dentist - Pediatric Dentistry in Fairlawn, OH
NPI Status: Active since November 17, 2005
Contact Information
3094 W MARKET ST
#260
FAIRLAWN, OH
ZIP 44333
Phone: (330) 867-5688
Fax: (330) 867-9921
- Individual
- Male
- Dentist
- Pediatric Dentistry
- Accepts Insurance
About JOHN GERSTENMAIER
This page provides the complete NPI Profile along with additional information for John Gerstenmaier, a provider established in Fairlawn, Ohio with a medical specialization in Dentist, focusing in pediatric dentistry . The healthcare provider is registered in the NPI registry with number 1669454302 assigned on November 2005. The practitioner's primary taxonomy code is 1223P0221X with license number 30014537 (OH). The provider is registered as an individual and his NPI record was last updated 18 years ago.
- NPI
- 1669454302
- Provider Name
- DR. JOHN HERBERT GERSTENMAIER JR. DDS
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3094 W MARKET ST #260 FAIRLAWN, OH 44333
- Location Phone
- (330) 867-5688
- Location Fax
- (330) 867-9921
- Mailing Address
- 431 SAINT ANDREWS DR AKRON, OH 44303
- Mailing Phone
- (330) 867-2474
- Is Sole Proprietor?
- No
- Enumeration Date
- 11-17-2005
- Last Update Date
- 07-08-2007
- Code Navigator
A dentist like John Gerstenmaier is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist Pediatric Dentistry
- Taxonomy Code
- 1223P0221X
- Type
- Dental Providers
- License No.
- 30014537
- License State
- OH
- Taxonomy Description
- An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 1223P0221X | Dental Providers | Dentist | 2901010057 (MI) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision - HMO
- Clear Silver - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
- Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential 9200 (+ Incentives) - HMO
- Anthem Bronze Essential 9200 Adult Dental/Vision (+ Incentives) - HMO
- Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 9200 (+ Incentives) - EPO
- Anthem Bronze Pathway HMO 7450 for HSA - HMO
- Anthem Bronze Pathway HMO 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway HMO 9200 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway HMO 9200 Adult Dental & Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Catastrophic Pathway 9200 (+ Incentives) - EPO
- Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Standard - HMO
- Catastrophic Standard - HMO
- Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Standard - HMO
- Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Standard - HMO
- Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Standard - HMO
- Catastrophic Standard - HMO
- Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Standard - HMO
- Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Standard - HMO
- BEST Life Superior Dental Plan - PPO
- BEST Essential Basic Dental Plan - PPO
- BEST Life Essentail Basic Dental Plan - PPO
- BEST Life Essentail Value Dental Plan - PPO
- BEST Life Essental Value Dental Plan - PPO
- BEST Life Essential Basic Dental - PPO
- BEST Life Essential Basic Dental Plan - PPO
- BEST Life Essential Basic Dental - PPO
- BEST Life Essential Basic Dental Plan - PPO
- BEST Life Essential Vakue Dental Plan - PPO
- BEST Life Essential Value Dental Plan - PPO
- BEST Life Essential Value Dental - PPO
- BEST Life Essential Value Dental Plan - PPO
- BEST Life Preferred Dental Plan - PPO
- BEST Life Preferred Dental - PPO
- BEST Life Preferred Dental Plan - PPO
- BEST Life Preferred Dental plan - PPO
- BEST Life Superior Dental - PPO
- BEST Life Superior Dental Plan - PPO
- BEST Life Superior Dental Plan - PPO
- Blue HSA Bronze - PPO
- Blue Protect - PPO
- Blue Saver Bronze - PPO
- Blue Value Gold - PPO
- Blue Value Silver - PPO
- Blue Access Gold for Business - PPO
- Blue Choice Platinum for Business - PPO
- Blue HSA Silver for Business - PPO
- Blue Saver Bronze for Business - PPO
- Blue Saver Gold for Business - PPO
- Blue Secure Gold for Business - PPO
- Blue Secure Silver for Business - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- Bronze First 7500 $25 Generic Drugs - HMO
- Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
- Core Gold 1500 $10 Generic Drugs - HMO
- Core Gold 1500 $10 Generic Drugs Adult Vision & Fitness - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Gold 1500 $15 Generic Drugs - HMO
- Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
- HDHP Preventive Silver 5500 $0 Select Drugs - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Low Premium Silver 6000 $3 Generic Drugs - HMO
- Low Premium Silver 6000 $3 Generic Drugs Adult Vision & Fitness - HMO
- Silver 5000 $20 Generic Drugs - HMO
- Silver 5000 $20 Generic Drugs Adult Vision & Fitness - HMO
- Delta Dental Individual Pediatric-Only PPO, EHB Certified - PPO
- Delta Dental Individual PPO Bronze Plan, EHB Certified - PPO
- Delta Dental Individual PPO Gold Plan, EHB Certified - PPO
- Delta Dental Individual PPO Silver Plan, EHB Certified - PPO
- Choice PPO Basic Kids - PPO
- Choice PPO Plus - PPO
- Choice PPO Premium - PPO
- Choice PPO Premium Kids - PPO
- Choice PPO Preventive - PPO
- EMI Health Advantage Co-Pay - PPO
- EMI Health Advantage PPO - PPO
- EMI Health Premier PPO (High) - PPO
- EMI Health Premier PPO (Low) - PPO
- Humana Dental Smart Choice - PPO
- Humana Dental Smart Choice - High - PPO
- Humana Dental Smart Choice - Lite - PPO
- Humana Dental Smart Choice - Low - PPO
- Humana Dental Smart Choice Basic - PPO
- Humana Dental Smart Choice- Lite - PPO
- Bronze $8,300 w/ Virtual & Wellness ON-EX - HMO
- Bronze HSA $7,300 ON-EX - HMO
- Bronze Standard w/ Virtual & Wellness - HMO
- Bronze Standard w/ Virtual & Wellness (CLE-Care) - HMO
- Gold Standard w/ Virtual & Wellness - HMO
- Gold Standard w/ Virtual & Wellness (CLE-CARE) - HMO
- Silver Standard w/ Virtual & Wellness - HMO
- Silver Standard w/ Virtual & Wellness (CLE-Care) - HMO
- SilverSelect w/ Virtual & Wellness ON-EX - HMO
- Young Adult Essentials ON-EX - HMO
- Paramount Dental Essential Plus Plan - EPO
- Paramount Dental Preventive Family Plan - EPO
- Paramount Dental Total Care Plan - EPO
- HRI Essential Plus Plan - HMO
- HRI Essential Plus Plan - PPO
- HRI Preventive Family Plan - HMO
- HRI Preventive Family Plan - PPO
- HRI Total Care Plan - HMO
- HRI Total Care Plan - PPO
- TruAssure Basic Adult or Child Dental Plan - PPO
- TruAssure Preferred Adult or Child Dental Plan - PPO
- TruAssure Preventive Dental Plan - PPO
- Smile Now Arizona - No Waiting Period PPO - PPO
- Smile Now Illinois - No Waiting Period PPO - PPO
- Smile Now Michigan - No Waiting Period PPO - PPO
- Smile Now Ohio - No Waiting Period PPO - PPO
- Smile Now Tennessee - No Waiting Period PPO - PPO
- Smile Now Texas- No Waiting Period Plan - PPO
- Smile Now Utah - No Waiting Period PPO - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0273814 | MEDICAID (05) | OH |
Reviews for DR. JOHN HERBERT GERSTENMAIER JR. DDS
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 6 | 9 | 4 | 5 | 4 | 3 | 0 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 12 | 9 | 8 | 5 | 8 | 3 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 1 + 2 + 9 + 8 + 5 + 8 + 3 + 0 + 24 = 68 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 68 = 2 | 2 | ||||||||
The NPI number 1669454302 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1922050780 | DR. JACK DENNIS KING MD Individual | Pediatrics | 3094 W MARKET ST SUITE 103 FAIRLAWN, OH 44333 (330) 836-9397 |
| 1205938289 | DR. MARK ALAN FORD DDS Individual | Dentist | 3094 W MARKET ST SUITE 348 FAIRLAWN, OH 44333 (330) 864-6410 |
| 1871629394 | DR. SUSAN SILVERMAN SIGALOW PH.D. Individual | Psychologist (Clinical) | 3094 W MARKET ST FAIRLAWN, OH 44333 (330) 864-7823 |
| 1568678043 | BANSRI SUNIL SHROFF D.M.D. Individual | Dentist (General Practice) | 3094 W MARKET ST STE. 250 FAIRLAWN, OH 44333 (330) 836-4467 |
| 1225247786 | PALLADIUM COUNSELING GROUP, INC. Organization | Social Worker (Clinical) | 3094 W MARKET ST SUITE 110 FAIRLAWN, OH 44333 (330) 836-8370 |
| 1093924557 | GABRIELLE ELIZABETH FAGGELLA M.S.S.A., L.I.S.W.-S Individual | Social Worker (Clinical) | 3094 W MARKET ST SUITE 110 FAIRLAWN, OH 44333 (330) 836-8370 |
| 1831378124 | WILLIAM E POLLEY JR INC Organization | Clinic/Center (Adult Day Care) | 3094 W MARKET ST FAIRLAWN, OH 44333 (330) 867-1205 |
| 1083895460 | ROTH FAMILY MEDICINE,LTD. Organization | Clinic/Center (Primary Care) | 3094 W MARKET ST SUITE 136 FAIRLAWN, OH 44333 (330) 864-0902 |
| 1528085503 | DR. MARTA B ROTH MD Individual | Family Medicine | 3094 W MARKET ST STE 136 FAIRLAWN, OH 44333 (330) 864-0902 |
| 1831511906 | JACKLYN HOFMANN LPCC Individual | Counselor (Professional) | 3094 W MARKET ST SUITE 105 FAIRLAWN, OH 44333 (440) 260-2916 |
| 1710328109 | ANGELA M BROWN LPCC Individual | Counselor (Professional) | 3094 W MARKET ST SUITE 105 FAIRLAWN, OH 44333 (440) 260-2916 |
| 1831523760 | MS. ELIZABETH S. HELMUTH Individual | Counselor (Professional) | 3094 W MARKET ST FAIRLAWN, OH 44333 (330) 571-0495 |
| 1578998688 | COREY M. FLING LPCC-S Individual | Counselor (Professional) | 3094 W MARKET ST SUITE 105 FAIRLAWN, OH 44333 (440) 260-8300 |
| 1699481788 | CAREYA PACE Individual | Case Manager/Care Coordinator | 3094 W MARKET ST FAIRLAWN, OH 44333 (330) 328-5575 |
| 1295421600 | REBECCA MILLER Individual | Social Worker | 3094 W MARKET ST FAIRLAWN, OH 44333 (234) 334-5589 |
| 1225720113 | YOLANDA THOMAS Individual | Case Manager/Care Coordinator | 3094 W MARKET ST FAIRLAWN, OH 44333 (330) 328-5575 |
| 1326864513 | MARCUS WALKER Individual | Case Manager/Care Coordinator | 3094 W MARKET ST FAIRLAWN, OH 44333 (234) 334-5589 |
| 1467278887 | TATIANA JARVIS Individual | Case Manager/Care Coordinator | 3094 W MARKET ST FAIRLAWN, OH 44333 (234) 334-5589 |
| 1639995038 | CHARMAINE REDDING Individual | Case Manager/Care Coordinator | 3094 W MARKET ST FAIRLAWN, OH 44333 (234) 334-5589 |
| 1487460036 | NICOLE MULLINS Individual | Case Manager/Care Coordinator | 3094 W MARKET ST FAIRLAWN, OH 44333 (234) 334-5589 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1669454302, enumerated in the NPI registry as an "individual" on November 17, 2005
The provider is located at 3094 W Market St #260 Fairlawn, Oh 44333 and the phone number is (330) 867-5688
The provider's speciality is Dentist with taxonomy code 1223P0221X with a focus in Pediatric Dentistry
The provider might be accepting Accepts: Aetna CVS Health, Ambetter from Meridian, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on November 17, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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