NPIMap

Organization Active NPI

Scott Dental Group L L C

  • Dental Clinic/Center
  • Loudonville, OH
National Provider Identifier
1073828786
Registry record updated Aug 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
16373 Issued in OH
Legal business name
SCOTT DENTAL GROUP L L C
Doing business as
Scott Dental Group L L C
Practice address
633 N Union St
Loudonville, OH 44842-1074
Phone
(419) 994-3111
Fax
(419) 994-4078
NPI assigned
Aug 18, 2010
Last updated
Aug 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2010

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

Authorized official

Name
Dr. Darrel L Scott, DDSNPI 1124175997
Title
Owner
Phone
(419) 994-3111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 16373 OH Primary

Addresses

Primary practice location

633 N Union St
Loudonville, OH 44842-1074

Mailing address

633 N Union St
Loudonville, OH 44842-1074
Phone (419) 994-3111

Other identifiers 2

IdentifierTypeStateIssuer
2969097MedicaidOH
0436611MedicaidOH

Other names 1

  • Scott Dental Group L L C Doing business as

National Provider Directory

National Provider Directory

Locations

633 N Union St
Loudonville, OH 44842
Phone (419) 994-3111

633 N Union St
Ste 633
Loudonville, OH 44842

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1282089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282089600000",
    "number": "1073828786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 N UNION ST",
            "city": "LOUDONVILLE",
            "state": "OH",
            "postal_code": "448421074",
            "telephone_number": "419-994-3111",
            "fax_number": "419-994-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 N UNION ST",
            "city": "LOUDONVILLE",
            "state": "OH",
            "postal_code": "448421074",
            "telephone_number": "419-994-3111",
            "fax_number": "419-994-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT DENTAL GROUP L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-18",
        "last_updated": "2010-08-18",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "DARREL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-994-3111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OH",
            "license": "16373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2969097",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0436611",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scott Dental Group L L C",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Loudonville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; 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.