Darrel L Scott, D.D.S. – General Practice Dentistry

Key facts

NPI: 1124175997
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: 30016373 (OH)
Practice address: 633 N Union St
Loudonville, OH 44842-1074
Phone: (419) 994-3111
Fax: (419) 994-4078
NPI assigned: Jan 4, 2007
Sex: Male
Sole proprietor: Yes

Organizations & group practices 1

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

Scott Dental Group L L C Dental Clinic/Center · Loudonville, OH · NPI 1073828786

NPD (past)

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
30016373	OH	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Scott Dental Group L L C		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry	1223G0001X	30016373	OH	Yes

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

Identifier	Type	State	Issuer
0436611	Medicaid	OH

Other providers in Loudonville, OH

All providers in Loudonville, OH · General Practice Dentistry in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.