NPIMap

Organization Active NPI

Family Dentistry

  • General Practice Dentistry
  • Urbana, OH
National Provider Identifier
1013143551
Registry record updated Jun 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FAMILY DENTISTRY
Practice address
1866 E US Highway 36
Urbana, OH 43078-9600
Phone
(937) 484-5775
Fax
(937) 484-5771
NPI assigned
Jun 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2009

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

Authorized official

Name
Dr. Ali Khaksarfard, DDS
Title
Owner/Doctor
Phone
(740) 852-7741

Specialties & licenses 1

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

Addresses

Primary practice location

1866 E US Highway 36
Urbana, OH 43078-9600

Mailing address

1866 E. US 36
Urbana, OH 43140
Phone (937) 484-5775

National Provider Directory

National Provider Directory

Locations

1866 E US Highway 36
Urbana, OH 43078
Phone (937) 484-5775

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244592000000",
    "number": "1013143551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1866 E. US 36",
            "city": "URBANA",
            "state": "OH",
            "postal_code": "43140",
            "telephone_number": "937-484-5775",
            "fax_number": "937-484-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1866 E US HIGHWAY 36",
            "city": "URBANA",
            "state": "OH",
            "postal_code": "430789600",
            "telephone_number": "937-484-5775",
            "fax_number": "937-484-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-10",
        "last_updated": "2009-06-10",
        "status": "A",
        "authorized_official_last_name": "KHAKSARFARD",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "740-852-7741",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; 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.