Unknown Individual – Dentist, NPI 1265535363

Unknown Individual is a healthcare provider. based in Lakewood, Ohio. specializing in Dentist. They hold a License No. 12760 (OH). The NPI Number for Unknown Individual is 1265535363

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1265535363
Phone
(216) 521-3486
Address
14701 DETROIT AVE #264
Deactivation Date
17 January 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Detroit Avenue, Edgewater, Lakewood, Cuyahoga County, Ohio, 44111, United States

    LAKEWOOD, OH 44107

    Phone: (216) 521-3486

    Fax: (216) 521-1640

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44107)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1265535363 as the unique 10-digit identifier.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Dentist in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Lakewood, Ohio.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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