Northwest Ohio Dental Specility Center,LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

30022360 Issued in OH

Legal business name

NORTHWEST OHIO DENTAL SPECILITY CENTER,LLC

Practice address

610 Broadmoor Ave
Napoleon, OH 43545-1288

Phone

(419) 592-5854

Fax

(419) 930-6500

NPI assigned

May 17, 2017

Last updated

Jun 12, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Stacy Lynn Freshour

Title

Practice Administrator

Phone

(419) 592-9956

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Dean Carpenter, D.D.S.

  • General Practice Dentistry
  • Napoleon, OH
  • NPI 1023217247
  NPD (past)

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497225600000",
    "number": "1144757469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 BROADMOOR AVE",
            "city": "NAPOLEON",
            "state": "OH",
            "postal_code": "435451288",
            "telephone_number": "419-592-9956",
            "fax_number": "419-930-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 BROADMOOR AVE",
            "city": "NAPOLEON",
            "state": "OH",
            "postal_code": "435451288",
            "telephone_number": "419-592-5854",
            "fax_number": "419-930-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST OHIO DENTAL SPECILITY CENTER,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-17",
        "last_updated": "2017-06-12",
        "status": "A",
        "authorized_official_last_name": "FRESHOUR",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "419-592-9956",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "30022360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ncop LLC (Orchards of Napoleon Living & Rehab)
• Erica Nemire
• Niki Parker Therapy Services LLC
• Tammey Marie Norden, LPN
• Northcrest Acres Nursing & Rehabilitation Center, LLC
• Northwest Ohio Educ SRV Ctr
• Elisabeth Nussbaum, LPN
• Stephanie Operacz, LSW
• Sherri Orr
• Jennifer Oyer

• Periodontics in Napoleon, OH
• Providers in Napoleon, OH by specialty
• Periodontics in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2017; 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.