NPI 1073528733 · live from the CMS NPI Registry
Advanced Dermatology Of North Central Ohio INC
Dermatology, Procedural Dermatology in Mansfield, OH. National Provider Identifier 1073528733, active.
NPI record
| NPI | 1073528733 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology, Procedural Dermatology 207NS0135X |
| Practice location | 770 Balgreen Dr, Ste 201, Mansfield, OH 44906 |
| Practice phone | 419-756-1600 |
| Mailing address | Po Box 735056, Dallas, TX 75373 |
| Enumerated | July 30, 2006 |
| Last updated | August 24, 2026 |
| Authorized official | Christ Ticoras, Owner/President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology | 207N00000X | — |
| Dermatology, Procedural Dermatology | 207NS0135X | — |
| Dermatology, Procedural Dermatology primary | 207NS0135X | 35063717T (OH) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.