Healthcare Provider Details

I. General information

NPI: 1821807884
Provider Name (Legal Business Name): MAPLE HEIGHTS DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2025
Last Update Date: 01/04/2025
Certification Date: 01/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20508 SOUTHGATE PARK BLVD
MAPLE HEIGHTS OH
44137-2900
US

IV. Provider business mailing address

95 W ORANGE HILL CIR
CHAGRIN FALLS OH
44022-2177
US

V. Phone/Fax

Practice location:
  • Phone: 216-663-2292
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. SHAWN SCHLESSEL
Title or Position: CO-OWNER
Credential: DDS
Phone: 440-263-5490