NPIMap

Organization Active NPI

South Vienna Family Dental

  • General Practice Dentistry
  • South Vienna, OH
National Provider Identifier
1023416294
Registry record updated Dec 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-022887 Issued in OH
Legal business name
SOUTH VIENNA FAMILY DENTAL
Practice address
8490 E National Rd
South Vienna, OH 45369-9707
Phone
(937) 568-3302
Fax
(937) 568-3304
NPI assigned
Dec 19, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2014

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

Authorized official

Name
Irfan Khan, DDS
Title
Owner
Phone
(937) 568-3302

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 30-022887 OH Primary

Addresses

Primary practice location

8490 E National Rd
South Vienna, OH 45369-9707

Mailing address

8490 E National Rd
PO Box 215
South Vienna, OH 45369-9707
Phone (937) 568-3302

National Provider Directory

National Provider Directory
Tax ID family
South Vienna Family Dental2 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.

Locations

8490 E National Rd
South Vienna, OH 45369
Phone (937) 568-3302

NPI Registry JSON

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

{
    "created_epoch": "1418947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418947200000",
    "number": "1023416294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8490 E NATIONAL RD",
            "address_2": "PO BOX 215",
            "city": "SOUTH VIENNA",
            "state": "OH",
            "postal_code": "453699707",
            "telephone_number": "937-568-3302",
            "fax_number": "937-568-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8490 E NATIONAL RD",
            "city": "SOUTH VIENNA",
            "state": "OH",
            "postal_code": "453699707",
            "telephone_number": "937-568-3302",
            "fax_number": "937-568-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH VIENNA FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-19",
        "last_updated": "2014-12-19",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "IRFAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-568-3302",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-022887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Vienna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.