NPIMap

Organization Active NPI

Unique Solutions Management Company LLC

Doing business as Klermont 4 Kids & Adults 2

  • General Practice Dentistry
  • Centerville, OH
National Provider Identifier
1114044625
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3001796 Issued in OH
Legal business name
UNIQUE SOLUTIONS MANAGEMENT COMPANY LLC
Doing business as
Klermont 4 Kids & Adults 2
Practice address
6850 Loop Rd
Centerville, OH 45459-2159
Phone
(937) 439-9366
Fax
(937) 439-6687
NPI assigned
Mar 22, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. William Rudolph Fry Jr., MBA
Title
Business Manager
Phone
(513) 735-9111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 3001796 OH Primary

Addresses

Primary practice location

6850 Loop Rd
Centerville, OH 45459-2159

Mailing address

6850 Loop Rd
Centerville, OH 45459-2159
Phone (937) 439-9366

Other identifiers 3

IdentifierTypeStateIssuer
2554267MedicaidOH
$$$$$$$$$OtherOHSSN
0263610MedicaidOH

Other names 1

  • Klermont 4 Kids & Adults 2 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Klermont 4 Kids Adults 22 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

6850 Loop Rd
Centerville, OH 45459
Phone (937) 439-9366

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114044625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6850 LOOP RD",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454592159",
            "telephone_number": "937-439-9366",
            "fax_number": "937-439-6687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 LOOP RD",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454592159",
            "telephone_number": "937-439-9366",
            "fax_number": "937-439-6687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIQUE SOLUTIONS MANAGEMENT COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FRY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "RUDOLPH",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "513-735-9111",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "3001796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2554267",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSN",
            "identifier": "$$$$$$$$$",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0263610",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Klermont 4 Kids & Adults 2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Centerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.