NPIMap

Organization Active NPI

Dental Services of Ohio

Doing business as ImmediaDent

  • Dentist
  • Reynoldsburg, OH
National Provider Identifier
1073648622
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DENTAL SERVICES OF OHIO
Doing business as
ImmediaDent
Practice address
6323 Tussing Rd
Reynoldsburg, OH 43068-3984
Phone
(614) 863-2222
Fax
(913) 800-6967
NPI assigned
Feb 23, 2007
Organization subpart
Yes
Parent organization
DENTAL SERVICES OF OHIOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Authorized official

Name
Amy Wheeler
Title
Credentialing Coordinator
Phone
(913) 800-6952

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 22001 OH

Addresses

Primary practice location

6323 Tussing Rd
Reynoldsburg, OH 43068-3984

Mailing address

PO Box 11568
Overland Park, KS 66207-4268
Phone (913) 428-1674

Other identifiers 1

IdentifierTypeStateIssuer
2569206MedicaidOH

Other names 1

  • ImmediaDent Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Services of Ohio James G Turk DDS Denean R Carr DDS Inc16 organizations share this tax ID, including this one
Part of
Dental Services of Ohio James G Turk DDS Denean R Carr DDS Inc

Other organizations with this tax ID 15

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

View all 15

Locations

6323 Tussing Rd
Reynoldsburg, OH 43068
Phone (614) 368-0296

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491955200000",
    "number": "1073648622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11568",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662074268",
            "telephone_number": "913-428-1674",
            "fax_number": "913-800-6967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6323 TUSSING RD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430683984",
            "telephone_number": "614-863-2222",
            "fax_number": "913-800-6967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SERVICES OF OHIO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL SERVICES OF OHIO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2017-04-12",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "913-800-6952"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "22001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2569206",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ImmediaDent",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reynoldsburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.