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Active NPI 1558010058 Individual Practitioner Female Practitioner

Elida Lica

Dentist - General Practice • North Olmsted, OH

Professional Overview & Biography Verified Profile Summary

Elida Lica is a registered healthcare professional specializing in Dentist - General Practice in North Olmsted, OH. Practice services are available at 4710 GREAT NORTHERN BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4710 Great Northern Blvd

North Olmsted, OH 440703427

Telephone 2167784486
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in North Olmsted, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.6 Yrs
Regional Practice Density
28 Specialists

Practicing in North Olmsted, OH (4287 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-11-25
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License OH 30.027657

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Charlene Pan , MD

Internal Medicine

NPI 1003337064

Doctor of Medicine (M.D.)

Julia Carroccio

Family Medicine

NPI 1003565268
Dr. Thomas Gautier , MD

Student in an Organized Health Care Education/Training Program

NPI 1003617333

Doctor of Medicine (M.D.)

Vissy Elad

Student in an Organized Health Care Education/Training Program

NPI 1003618638
Shivangi Patel

Student in an Organized Health Care Education/Training Program

NPI 1003619271
Dr. Miranda Viars , MD

Student in an Organized Health Care Education/Training Program

NPI 1003662099

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Practice Location November 25, 2024

Registered at 4710 GREAT NORTHERN BLVD, NORTH OLMSTED, OH 440703427 (Tel: 2167784486)

NPI Profile Active March 22, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location March 22, 2022

Registered at 2500 METROHEALTH DR, CLEVELAND, OH 441091900 (Tel: 2167784486)

📍
Updated Business Mailing Address March 22, 2022

Registered at 21800 RIVER OAKS DR, ROCKY RIVER, OH 441163127 (Tel: 2162589243)

👤
Provider Name / Credentials Updated March 22, 2022

Recorded as ELIDA LICA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 22, 2022

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 22, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1558010058
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 22, 2022
Last Update: November 25, 2024
Sole Proprietor: No

Mailing Address

21800 River Oaks Dr

Rocky River, OH 441163127

Phone: 2162589243

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.