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General NPI Number Information
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NPI Number | 1447469036
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Entity Type | Individual
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Provider Name | JOHN R VANNI D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 02/04/2016
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Provider Practice Location Address
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Address Line | 5187 MAYFIELD RD SUITE 40
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City | LYNDHURST
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State | OH
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Zip | 44124-2468
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Country | US
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Telephone | 440-446-0110
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Fax |
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Provider Business Mailing Address
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Address Line | 5187 MAYFIELD RD STE 40
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City | LYNDHURST
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State | OH
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Zip | 44124-2466
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Country | US
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Telephone | 440-446-0110
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30-17434
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License Number State | OH
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