Organization Active NPI

Pinnacle One Dental Group

Doing business as Cincinnati Dental Services Eastgate

  • General Practice Dentistry
  • Cincinnati, OH
National Provider Identifier
1174540710
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14417 Issued in OH
Legal business name
PINNACLE ONE DENTAL GROUP
Doing business as
Cincinnati Dental Services Eastgate
Practice address
4360 Ferguson Dr Ste 140
Cincinnati, OH 45245-1683
Phone
(513) 753-6446
NPI assigned
Jul 17, 2006
Organization subpart
Yes
Parent organization
PINNACLE ONE DENTAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 14417 OH Primary

Addresses

Primary practice location

4360 Ferguson Dr Ste 140
Cincinnati, OH 45245-1683

Mailing address

4360 Ferguson Dr Ste 140
Cincinnati, OH 45245-1683
Phone (513) 753-6446

Other names 1

  • Cincinnati Dental Services Eastgate Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pinnacle One Dental Group Delisle PC10 organizations share this tax ID, including this one
Part of
Pinnacle One Dental Group Delisle PC

Other organizations with this tax ID 9

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

Locations

4360 Ferguson Dr
Ste 140
Cincinnati, OH 45245
Phone (513) 753-6446

4360 Ferguson Dr
Cincinnati, OH 45245
Phone (513) 752-0113

Practitioners & affiliated clinicians

Practitioners 5

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": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1174540710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4360 FERGUSON DR STE 140",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452451683",
            "telephone_number": "513-753-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4360 FERGUSON DR STE 140",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452451683",
            "telephone_number": "513-753-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE ONE DENTAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PINNACLE ONE DENTAL GROUP",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "14417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cincinnati Dental Services Eastgate",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.