Family Orthodontics of Ohio Jim Shealy DDS LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

FAMILY ORTHODONTICS OF OHIO JIM SHEALY DDS LLC

Practice address

4440 Linden Ave
Dayton, OH 45432-3031

Phone

(937) 252-8651

NPI assigned

Jan 8, 2018

Organization subpart

No

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

Authorized official

Name

Tamonia Leonard

Title

Credentialing Specialist

Phone

(678) 244-4844

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Richard J Mori, DMD LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Dayton, OH
  • NPI 1750375317
  NPD (past)
• John Jeffrey Simindinger, DDS, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Dayton, OH
  • NPI 1649949801
  NPD (past)

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515369600000",
    "number": "1063929487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 SPRING ST NW STE 600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 LINDEN AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454323031",
            "telephone_number": "937-252-8651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY ORTHODONTICS OF OHIO JIM SHEALY DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-08",
        "last_updated": "2018-01-08",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "TAMONIA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "678-244-4844"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destry P. Fallen, LISW-S
• Olivia Marie Falter
• Sharda Fambro
• Family First Vision Care Kentucky, LLC
• Family Matterz LTD.
• Family Wellness & Empowerment Program LLC
• Kaili Fan, MD
• Lindsey Fancett, PA-C
• Cheryl Fannin
• Sydney Fannin

• Orthodontics and Dentofacial Orthopedics Dentistry in Dayton, OH
• Providers in Dayton, OH by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2018; 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.