NPIMap

Organization Active NPI

Mobile Dental Services of Ohio

  • Dentist
  • Sylvania, OH
National Provider Identifier
1205965134
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MOBILE DENTAL SERVICES OF OHIO
Practice address
5151 S. Main St.
Sylvania, OH 43560-2184
Phone
(419) 882-5000
Fax
(419) 882-5008
NPI assigned
Mar 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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

Authorized official

Name
Michael J Kastner, DDS
Title
Official
Phone
(419) 882-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

5151 S. Main St.
Sylvania, OH 43560-2184

Mailing address

5151 S. Main St.
Sylvania, OH 43560-2184
Phone (419) 882-5000

Other identifiers 1

IdentifierTypeStateIssuer
2719160MedicaidOH

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455667200000",
    "number": "1205965134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 S. MAIN ST.",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602184",
            "telephone_number": "419-882-5000",
            "fax_number": "419-882-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 S. MAIN ST.",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602184",
            "telephone_number": "419-882-5000",
            "fax_number": "419-882-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE DENTAL SERVICES OF OHIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2016-02-17",
        "status": "A",
        "authorized_official_last_name": "KASTNER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICIAL",
        "authorized_official_telephone_number": "419-882-5000",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2719160",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; 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.