Provider Demographics
NPI:1164515714
Name:ANTHONY FORDE D.D.S. INC.
Entity Type:Organization
Organization Name:ANTHONY FORDE D.D.S. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:FORDE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:440-842-2203
Mailing Address - Street 1:6820 RIDGE ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-5647
Mailing Address - Country:US
Mailing Address - Phone:440-842-2203
Mailing Address - Fax:440-842-3101
Practice Address - Street 1:6820 RIDGE ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5647
Practice Address - Country:US
Practice Address - Phone:440-842-2203
Practice Address - Fax:440-842-3101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300142871223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0454772Medicare ID - Type Unspecified
OHT-46987Medicare UPIN