NPIMap

Organization Active NPI

Wauseon Dental Group L.L.C.

  • General Practice Dentistry
  • Wauseon, OH
National Provider Identifier
1003231994
Registry record updated Feb 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30019920 Issued in OH
Legal business name
WAUSEON DENTAL GROUP L.L.C.
Practice address
229 N Franklin St
Wauseon, OH 43567-1265
Phone
(419) 337-2391
Fax
(419) 335-0700
NPI assigned
Feb 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Missi L Pelok
Title
Office MGR.
Phone
(419) 337-2391

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 30019920 OH Primary

Addresses

Primary practice location

229 N Franklin St
Wauseon, OH 43567-1265

Mailing address

229 N Franklin St
Wauseon, OH 43567-1265
Phone (419) 337-2391

National Provider Directory

National Provider Directory
Tax ID family
Wauseon Dental Group LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1393545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393545600000",
    "number": "1003231994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 N FRANKLIN ST",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671265",
            "telephone_number": "419-337-2391",
            "fax_number": "419-335-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 N FRANKLIN ST",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671265",
            "telephone_number": "419-337-2391",
            "fax_number": "419-335-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUSEON DENTAL GROUP L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-28",
        "last_updated": "2014-02-28",
        "status": "A",
        "authorized_official_last_name": "PELOK",
        "authorized_official_first_name": "MISSI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MGR.",
        "authorized_official_telephone_number": "419-337-2391"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30019920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauseon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.