THOMAS J DIETRICH DDS, MD
NPI 1841301942
Dentist - Oral and Maxillofacial Surgery in Canton, OH
NPI Status: Active since August 31, 2006
Contact Information
4774 MUNSON ST NW
SUITE 102
CANTON, OH
ZIP 44718
Phone: (330) 494-6653
Fax: (330) 494-6630
- Individual
- Male
- Dentist
- Oral and Maxillofacial Surgery
- Accepts Insurance
- Opted-Out Medicare
About THOMAS DIETRICH
This page provides the complete NPI Profile along with additional information for Thomas Dietrich, a provider established in Canton, Ohio with a medical specialization in Dentist, focusing in oral and maxillofacial surgery . The healthcare provider is registered in the NPI registry with number 1841301942 assigned on August 2006. The practitioner's primary taxonomy code is 1223S0112X with license number 21924 (OH). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1841301942
- Provider Name
- THOMAS J DIETRICH DDS, MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4774 MUNSON ST NW SUITE 102 CANTON, OH 44718
- Location Phone
- (330) 494-6653
- Location Fax
- (330) 494-6630
- Mailing Address
- 4774 MUNSON ST NW SUITE 102 CANTON, OH 44718
- Mailing Phone
- (330) 494-6653
- Mailing Fax
- (330) 494-6630
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-31-2006
- Last Update Date
- 08-31-2010
- Code Navigator
A dentist like Thomas Dietrich 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.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Thomas Dietrich opted out of Medicare effective on 04-01-2022 until 04-01-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
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 Oral and Maxillofacial Surgery
- Taxonomy Code
- 1223S0112X
- Type
- Dental Providers
- License No.
- 21924
- License State
- OH
- Taxonomy Description
- An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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 | 1223P0106X | Dental Providers | Dentist | 21924 (OH) |
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
- AultCare Bronze 7000 Select - PPO
- AultCare Bronze 8550 Select No Pediatric Dental - PPO
- AultCare Gold 1100 Select - PPO
- AultCare Gold 1100 Select No Pediatric Dental - PPO
- AultCare Silver 6550 Select No Pediatric Dental - PPO
- AultCare Standard Bronze Select No Pediatric Dental - PPO
- AultCare Standard Gold Select No Pediatric Dental - PPO
- AultCare Standard Silver Select No Pediatric Dental - PPO
- AultCare Bronze 5500 - PPO
- AultCare Bronze 7050 - PPO
- AultCare Gold 1000 - PPO
- AultCare Gold 1200 - PPO
- AultCare Gold 1800 - PPO
- AultCare Gold 2850 - PPO
- AultCare Gold 3150 - PPO
- AultCare Platinum 1200 - PPO
- AultCare Platinum 1800 Health Savings 500 - PPO
- AultCare Platinum 300 - PPO
- AultCare Platinum 500 - PPO
- AultCare Silver 2550 - PPO
- 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
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 04-01-2022
Opt-Out End Date: 04-01-2026
Eligible to Order and Refer? No
Reviews for THOMAS J DIETRICH DDS, MD
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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 | 8 | 4 | 1 | 3 | 0 | 1 | 9 | 4 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 8 | 1 | 6 | 0 | 2 | 9 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 8 + 1 + 6 + 0 + 2 + 9 + 8 + 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 1841301942 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 17 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1053417287 | DR. PHILIP GEROW CAMERON DC Individual | Chiropractor | 4774 MUNSON ST NW #302 CANTON, OH 44718 (330) 494-0422 |
| 1598861726 | DR. JEFFREY STEVEN FEDORKO DC Individual | Chiropractor | 4774 MUNSON ST NW #302 CANTON, OH 44718 (330) 494-0422 |
| 1164543864 | MARK R. GRUBB, MD, INC. Organization | Durable Medical Equipment & Medical Supplies | 4774 MUNSON ST NW SUITE 302 CANTON, OH 44718 (330) 966-9328 |
| 1427260223 | MARK R. GRUBB, MD, INC. Organization | Orthopaedic Surgery | 4774 MUNSON ST NW SUITE 302 CANTON, OH 44718 (330) 966-9328 |
| 1457527392 | DR. GREGGORY NICHOLAS ELEFTERIN DDS Individual | Dentist (General Practice) | 4774 MUNSON ST NW SUITE 201 CANTON, OH 44718 (330) 494-3133 |
| 1164731519 | DR. DANIA KAFRI DDS, MSD Individual | Dentist (Endodontics) | 4774 MUNSON ST NW SUITE 304 CANTON, OH 44718 (330) 497-5331 |
| 1023358280 | PREMIER HEALTH AND WELLNESS CENTER, LLC Organization | Family Medicine | 4774 MUNSON ST NW CANTON, OH 44718 (330) 754-4431 |
| 1912278730 | DR. LARISSA MARIE TILLEY D.C. Individual | Chiropractor | 4774 MUNSON ST NW SUITE 302 CANTON, OH 44718 (330) 494-0422 |
| 1821093139 | DR. GEORGE THOMAS WILLIAMS DDS Individual | Dentist (General Practice) | 4774 MUNSON ST NW SUITE 303 CANTON, OH 44718 (330) 497-7700 |
| 1275910226 | WILLIAMS FAMILY DENTAL GROUP INC Organization | Clinic/Center (Dental) | 4774 MUNSON ST NW SUITE 303 CANTON, OH 44718 (330) 497-7700 |
| 1902279094 | PROGRESSIVE MEDICAL SPECIALISTS Organization | Internal Medicine (Nephrology) | 4774 MUNSON ST NW SUITE 204 CANTON, OH 44718 (330) 475-2370 |
| 1457760068 | DR. GEORGE ROBERT WILLIAMS DDS Individual | Dentist | 4774 MUNSON ST NW STE 303 CANTON, OH 44718 (330) 497-7700 |
| 1336122175 | DR. MICHAEL G GRIMES MD Individual | Family Medicine | 4774 MUNSON ST NW SUITE 401 CANTON, OH 44718 (330) 754-4431 |
| 1770929408 | DR. MAXIMILLIAN GUSTAV BEUSHAUSEN DMD Individual | Dentist (Oral and Maxillofacial Surgery) | 4774 MUNSON ST NW SUITE 102 CANTON, OH 44718 (330) 494-6653 |
| 1528153533 | DIETRICH & ASSOCIATES ORAL AND MAXILLOFACIAL SURGERY, INC. Organization | Dentist (Oral and Maxillofacial Surgery) | 4774 MUNSON ST NW SUITE 102 CANTON, OH 44718 (330) 494-6653 |
| 1144326356 | FEDORKO CHIROPRACTIC HEALTH CTR Organization | Chiropractor | 4774 MUNSON ST NW SUITE 302 CANTON, OH 44718 (330) 494-0422 |
| 1477697142 | WILLIAM S. ALFORD DO, INC Organization | Obstetrics & Gynecology | 4774 MUNSON ST NW SUITE 103 CANTON, OH 44718 (330) 833-5530 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1841301942, enumerated in the NPI registry as an "individual" on August 31, 2006
The provider is located at 4774 Munson St Nw Suite 102 Canton, Oh 44718 and the phone number is (330) 494-6653
The provider's speciality is Dentist with taxonomy code 1223S0112X with a focus in Oral and Maxillofacial Surgery
The provider might be accepting Accepts: Aetna CVS Health, AultCare Insurance Company and. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
No, the provider signed an affidavit on April 01, 2022 to opt-out of the Medicare program. The provider is excluded from the Medicare program until April 01, 2026.
This NPI record was last updated on August 31, 2006. 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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