Dr. Dellagatta & Associates (Southern Park), Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DR. DELLAGATTA & ASSOCIATES (SOUTHERN PARK), INC.

Practice address

930 Boardman-Poland Road
Boardman, OH 44512

Phone

(330) 629-8884

Fax

(216) 584-1070

NPI assigned

Jan 26, 2006

Organization subpart

Yes

Parent organization

DENTALONE PARTNERS, INCAs reported in NPPES

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

Authorized official

Name

Lauren Hill

Title

RCM, Director

Phone

(972) 930-7707

Specialties & licenses 7

Addresses

Other names 1

• DentalWorks Doing business as

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1235109604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860036",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860036",
            "telephone_number": "330-629-8884",
            "fax_number": "216-584-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 BOARDMAN-POLAND ROAD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "44512",
            "telephone_number": "330-629-8884",
            "fax_number": "216-584-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. DELLAGATTA & ASSOCIATES (SOUTHERN PARK), INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTALONE PARTNERS, INC",
        "enumeration_date": "2006-01-26",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "RCM, DIRECTOR",
        "authorized_official_telephone_number": "972-930-7707"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DentalWorks",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DentalWorks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Boardman, OH
• Providers in Boardman, 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 Sep 22, 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.