TM Wyland Dental Lab II

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

TM WYLAND DENTAL LAB II

Doing business as

Lordstown Dental Clinic

Practice address

947 Hallock Young Rd SW
Warren, OH 44481-9636

Phone

(330) 824-2515

Fax

(330) 824-2333

NPI assigned

Nov 19, 2014

Last updated

Nov 19, 2014By 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

Mr. Andrew Alan Biddle

Title

President

Phone

(330) 824-2515

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Lordstown Dental Clinic Doing business as

Tax ID family

Lordstown Dental Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• T M Wyland Dental Lab II Inc

  • Dentist
  • Warren, OH
  • NPI 1487877874
  NPD tax ID

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.

• Bert L Heisser, DDS

  • Dentist
  • Warren, OH
  • NPI 1013081868
  NPD (past)

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

{
    "created_epoch": "1416355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416355200000",
    "number": "1205233277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 HALLOCK YOUNG RD SW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444819636",
            "telephone_number": "330-824-2515",
            "fax_number": "330-824-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 HALLOCK YOUNG RD SW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444819636",
            "telephone_number": "330-824-2515",
            "fax_number": "330-824-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TM WYLAND DENTAL LAB II",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-19",
        "last_updated": "2014-11-19",
        "status": "A",
        "authorized_official_last_name": "BIDDLE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-824-2515",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0541677",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2037076",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lordstown Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Debby Tinkham, CDCA
• Arash Tirgan, MD
• April Titus
• TLC Home Healthcare LLC
• TLC Private Care, LLC
• Amber Toler, CDCA
• James Tomsich
• Jessica Toot
• Christine D. Toporcer, LPCC
• Isaac Torem, MD

• General Practice Dentistry in Warren, OH
• Providers in Warren, 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 Nov 19, 2014; 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.