Individual provider Active NPI

Eric Wayne Warnock, D.D.S

  • General Practice Dentistry
  • Maumee, OH
National Provider Identifier
1114931656
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14509 Issued in OH
Practice address
959 Illinois Ave
Suite a
Maumee, OH 43537-1743
Phone
(419) 891-0527
Fax
(419) 891-0719
NPI assigned
Jul 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14509 OH Primary

Addresses

Primary practice location

959 Illinois Ave
Suite a
Maumee, OH 43537-1743

Mailing address

959 Illinois Ave
Suite a
Maumee, OH 43537-1743
Phone (419) 891-0527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14509OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114931656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 ILLINOIS AVE",
            "address_2": "SUITE A",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371743",
            "telephone_number": "419-891-0527",
            "fax_number": "419-891-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 ILLINOIS AVE",
            "address_2": "SUITE A",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371743",
            "telephone_number": "419-891-0527",
            "fax_number": "419-891-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNOCK",
        "first_name": "ERIC",
        "middle_name": "WAYNE",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "14509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.