NPIMap

Organization Active NPI

West Broad Dental - Jeffrey R. Fisher DDS, Inc.

  • General Practice Dentistry
  • Galloway, OH
National Provider Identifier
1124880125
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WEST BROAD DENTAL - JEFFREY R. FISHER DDS, INC.
Practice address
5688 W Broad St Ste B
Galloway, OH 43119-8127
Phone
(614) 870-8474
Fax
(614) 870-8475
NPI assigned
Jan 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Authorized official

Name
Jeffrey Fisher, DDSNPI 1295935740
Title
Owner/Dentist
Phone
(614) 870-8474

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

5688 W Broad St Ste B
Galloway, OH 43119-8127

Mailing address

5688 W Broad St Ste B
Galloway, OH 43119-8127
Phone (614) 870-8474

National Provider Directory

National Provider Directory

Locations

5688 W Broad St
#B
Galloway, OH 43119
Phone (614) 870-8474

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1124880125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5688 W BROAD ST STE B",
            "city": "GALLOWAY",
            "state": "OH",
            "postal_code": "431198127",
            "telephone_number": "614-870-8474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5688 W BROAD ST STE B",
            "city": "GALLOWAY",
            "state": "OH",
            "postal_code": "431198127",
            "telephone_number": "614-870-8474",
            "fax_number": "614-870-8475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST BROAD DENTAL - JEFFREY R. FISHER DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "614-870-8474",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galloway, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.