Raizen, Michael Jay

Raizen, Michael Jay is an individual health care provider with primary practice located at 600 W 3Rd St , Mansfield OH 44906-2633. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dentist. Dental Providers / Dentist is his primary health care specialty. Raizen, Michael Jay can be contacted via phone (419) 522-1939.

Contact Information

Primary practice address
600 W 3Rd St Mansfield OH 44906-2633
Phone: (419) 522-1939
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 106233 Colorado
Dental Providers / Dentist 122300000X 22695 Ohio

Profile Details

NPI number 1417951781
LBN Legal business name Raizen, Michael Jay
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2005
Last updated Aug 9th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417951781 NPPES
Colorado MEDICAID 02062339

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