Darrel L Scott, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30016373 Issued in OH

Practice address

633 N Union St
Loudonville, OH 44842-1074

Phone

(419) 994-3111

Fax

(419) 994-4078

NPI assigned

Jan 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Scott Dental Group L L C

  • Dental Clinic/Center
  • Loudonville, OH
  • NPI 1073828786
  NPD (past) Authorized official

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124175997",
    "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": {
        "last_name": "SCOTT",
        "first_name": "DARREL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30016373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0436611",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert D Berry, DC, Inc
• Abigail Rae Rohde, RN
• Marcus David Rohde
• Tiffany Marie Ryan, LPN
• Scott Dental Group L L C
• Tyler Lynn Scott, DDS
• Sean Phillips Recovery Center LLC (Sean Phillips Recovery Center)
• Nicole Shannon
• Trina Smith, LPN
• Rileigh Lynn Stake, COTA/L

• General Practice Dentistry in Loudonville, OH
• Providers in Loudonville, OH by specialty
• General Practice Dentistry in Ohio

• 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.