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ADVANCED DERMATOLOGY OF NORTH CENTRAL OHIO INC NPI 1073528733


NPI Information

NPI: 1073528733
Provider Name: ADVANCED DERMATOLOGY OF NORTH CENTRAL OHIO INC

Doing Business As: ADVANCED DERMATOLOGY OF NORTH CENTRAL OHIO INC

Classification: Dermatology - 207NS0135X
Entity Type: Organization

Specialization: Procedural Dermatology

CLIA Number: 36D0962642

Address:
770 BALGREEN DR
STE 201
MANSFIELD, OH
ZIP 44906
Phone: (419) 756-1600
Get Directions

ADVANCED DERMATOLOGY OF NORTH CENTRAL OHIO INC is a procedural dermatology dermatology in Mansfield, OH. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). ADVANCED DERMATOLOGY OF NORTH CENTRAL OHIO INC NPI is 1073528733. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Advanced Dermatology Of North Central Ohio Inc.

The provider's business location address is:

770 BALGREEN DR
STE 201
MANSFIELD, OH
ZIP 44906-106
Phone: (419) 756-1600
Fax: (419) 775-1196

The provider's authorized official is Christ John Ticoras .
The authorized official title is Owner/president and has the following contact phone number (419) 756-1600.

The CLIA number assigned to this NPI record is 36D0962642 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/30/2006 and was last updated on 8/21/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207NS0135XDermatologyProcedural DermatologyNo
2207N00000XDermatologyNo
3207NS0135XDermatologyProcedural Dermatology35063717TOHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1CH7642MEDICARE PINOHIO
22251316MEDICAIDOHIO
39315311MEDICARE PINOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.