Doctor profile · Federal record
Dr. Jun Soetanto, DMD
Dentist · Cleveland, OH
- NPI 1154762599
- 13 yrs on file
- Male
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
11201 Shaker Blvd, Suite 136
Cleveland, OH 441043869
(216) 368-7238
Credentials & registration
- NPI registered
- July 2013 — 13 yrs on file
- Specialty taxonomy
- 122300000X — NUCC code
- State license (1)
- Ohio #RES 33.79
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1154762599. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$49
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Patterson Companies, INC. | 1 | $48.84 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
213
Patients
110
Total drug cost
$947
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Amoxicillin | Generic | 177 | 97 | $436 |
| Clindamycin Hcl | Generic | 20 | 13 | $147 |
| Prevident (Fluoride (Sodium)) | Brand | 16 | 0 | $364 |
Frequently asked questions
What is Dr. Jun Soetanto's medical specialty?
Dr. Jun Soetanto practices Dentist in Cleveland, OH.
Where does Dr. Jun Soetanto practice?
Dr. Jun Soetanto practices at 11201 Shaker Blvd, Cleveland, OH 441043869. Office phone: 2163687238.
What is Dr. Jun Soetanto's NPI?
Dr. Jun Soetanto's National Provider Identifier (NPI) is 1154762599, issued by NPPES.