NPIMap

Organization Active NPI

Dental Services of Ohio

Doing business as ImmediaDent

  • Dental Clinic/Center
  • Dayton, OH
National Provider Identifier
1205019817
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
30-021038 Issued in OH
Legal business name
DENTAL SERVICES OF OHIO
Doing business as
ImmediaDent
Practice address
7420 Miller LN
Dayton, OH 45414-2442
Phone
(937) 890-8901
Fax
(913) 800-6967
NPI assigned
Dec 6, 2007
Last updated
Apr 12, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL SERVICES OF OHIOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Authorized official

Name
Amy Wheeler
Title
Credentialing Coordinator
Phone
(913) 800-6952

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 30-021038 OH Primary
Dentist 122300000X NU

Addresses

Primary practice location

7420 Miller LN
Dayton, OH 45414-2442

Mailing address

PO Box 11568
Overland Park, KS 66207-4268
Phone (913) 428-1674

Other names 1

  • ImmediaDent Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Services of Ohio James G Turk DDS Denean R Carr DDS Inc16 organizations share this tax ID, including this one
Part of
Dental Services of Ohio James G Turk DDS Denean R Carr DDS Inc

Other organizations with this tax ID 15

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

View all 15

Locations

7420 Miller Ln
Dayton, OH 45414
Phone (937) 315-0429

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491955200000",
    "number": "1205019817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11568",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662074268",
            "telephone_number": "913-428-1674",
            "fax_number": "913-800-6967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7420 MILLER LN",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454142442",
            "telephone_number": "937-890-8901",
            "fax_number": "913-800-6967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SERVICES OF OHIO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL SERVICES OF OHIO",
        "enumeration_date": "2007-12-06",
        "last_updated": "2017-04-12",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "913-800-6952"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OH",
            "license": "30-021038",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ImmediaDent",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 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.