NPIMap

Organization Active NPI

Dayton Dental Collaborative

  • General Practice Dentistry
  • Dayton, OH
National Provider Identifier
1144465907
Registry record updated Dec 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15799 Issued in OH
Legal business name
DAYTON DENTAL COLLABORATIVE
Practice address
5685 Far Hills Ave
Dayton, OH 45429-2226
Phone
(937) 435-5163
Fax
(937) 291-9353
NPI assigned
Dec 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2008

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

Authorized official

Name
R. Gregory Shelhouse, DDS
Title
Owner Dentist
Phone
(937) 435-5163

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 15799 OH Primary

Addresses

Primary practice location

5685 Far Hills Ave
Dayton, OH 45429-2226

Mailing address

5685 Far Hills Ave
Dayton, OH 45429-2226
Phone (937) 435-5163

National Provider Directory

National Provider Directory

Locations

5685 Far Hills Ave
Dayton, OH 45429
Phone (937) 256-3741

Practitioners & affiliated clinicians

Practitioners 9

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": "1228780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228780800000",
    "number": "1144465907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5685 FAR HILLS AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292226",
            "telephone_number": "937-435-5163",
            "fax_number": "937-291-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5685 FAR HILLS AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292226",
            "telephone_number": "937-435-5163",
            "fax_number": "937-291-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAYTON DENTAL COLLABORATIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-09",
        "last_updated": "2008-12-09",
        "status": "A",
        "authorized_official_last_name": "SHELHOUSE",
        "authorized_official_first_name": "R. GREGORY",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "937-435-5163",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "15799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; 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.