NPIMap

Organization Active NPI

Ohio Dental Professionals, Delisle, P.C.

Doing business as Dental Care of Heritage Lakes

  • General Practice Dentistry
  • Hilliard, OH
National Provider Identifier
1124726922
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
OHIO DENTAL PROFESSIONALS, DELISLE, P.C.
Doing business as
Dental Care of Heritage Lakes
Practice address
3905 Berry Leaf LN
Hilliard, OH 43026-3140
Phone
(614) 980-0773
NPI assigned
Feb 21, 2023
Last updated
Feb 21, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
OHIO DENTAL PROFESSIONALS, DELISLE, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Authorized official

Name
Hillary Thull
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

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

Addresses

Primary practice location

3905 Berry Leaf LN
Hilliard, OH 43026-3140

Mailing address

3905 Berry Leaf LN
Hilliard, OH 43026-3140

Other names 1

  • Dental Care of Heritage Lakes Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of Oh Richard E Workman DMD PS39 organizations share this tax ID, including this one
Part of
Heartland Dental Care of Oh Richard E Workman DMD PS

Other organizations with this tax ID 38

Organizations that report the same tax identification number in the National Provider Directory.

View all 38

Locations

3905 Berry Leaf Ln
Hilliard, OH 43026
Phone (614) 771-5960

NPI Registry JSON

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1124726922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 BERRY LEAF LN",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430263140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 BERRY LEAF LN",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430263140",
            "telephone_number": "614-980-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO DENTAL PROFESSIONALS, DELISLE, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OHIO DENTAL PROFESSIONALS, DELISLE, P.C.",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care of Heritage Lakes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hilliard, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.