Prohealth Mobile Dental Services Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.023358 Issued in OH

Legal business name

PROHEALTH MOBILE DENTAL SERVICES INC

Practice address

12611 Eckel Junction Rd
Perrysburg, OH 43551-1304

Phone

(419) 873-6326

NPI assigned

Jun 5, 2012

Last updated

Aug 11, 2015By 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

Richie L Adams

Title

Owner/Ceo

Phone

(419) 491-7150

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439251200000",
    "number": "1235490467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12611 ECKEL JUNCTION RD",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435511304",
            "telephone_number": "419-873-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12611 ECKEL JUNCTION RD",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435511304",
            "telephone_number": "419-873-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH MOBILE DENTAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-05",
        "last_updated": "2015-08-11",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "RICHIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "419-491-7150"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.023358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premier Denture Center LLC
• Premier Practitioners, LLC
• Premiere Counseling Services, LLC
• Prevention Partners of Wood County
• Professional Dental Alliance, LLC (Corner Dental Perrysburg)
• Prohealth Mobile X-Ray LLC
• Prohealth Mobile X-Ray LLC
• Prohealth Partners Inc.
• Prohealth Physician Group LLC
• Prohealth Physician Group, LLC

• General Practice Dentistry in Perrysburg, OH
• Providers in Perrysburg, 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 11, 2015; 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.