Family Dental Team, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30-012228 Issued in OH

Legal business name

FAMILY DENTAL TEAM, INC.

Practice address

620 Ridgewood Xing
Suite K
Fairlawn, OH 44333-3531

Phone

(330) 376-9424

Fax

(330) 376-2298

NPI assigned

Mar 25, 2008

Organization subpart

No

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

Authorized official

Name

Dr. James D George, D.D.S.

Title

President/Owner

Phone

(330) 376-9424

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250121600000",
    "number": "1205008828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 RIDGEWOOD XING",
            "address_2": "SUITE K",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333531",
            "telephone_number": "330-376-9424",
            "fax_number": "330-376-2298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 RIDGEWOOD XING",
            "address_2": "SUITE K",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333531",
            "telephone_number": "330-376-9424",
            "fax_number": "330-376-2298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL TEAM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2009-08-13",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "330-376-9424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-012228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2531148",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fairlawn Healthcare LLC
• Fairlawn Opco, LLC
• Fairlawn Opco, LLC
• Fairlawn R&N Opco, LLC
• Lauren Faller
• Family First Residentials
• Erin Marie Farrer, PH.D.
• Danielle Louise Fascione
• Dorlan Fedrick Jr.
• Gina L Fegatelli, CNP

• General Practice Dentistry in Fairlawn, OH
• Providers in Fairlawn, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2009; 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.