NPIMap

Organization Active NPI

State of Delaware

  • Dental Clinic/Center
  • Dover, DE
National Provider Identifier
1245302017
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
STATE OF DELAWARE
Practice address
417 Federal St
Dover, DE 19901-3635
Phone
(302) 744-4554
Fax
(302) 661-7229
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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

Authorized official

Name
Gregory B McClure, DMD
Title
Dental Director
Phone
(302) 744-4554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

417 Federal St
Dover, DE 19901-3635

Mailing address

417 Federal St
Dover, DE 19901-3635
Phone (302) 744-4554

Other identifiers 1

IdentifierTypeStateIssuer
0000086048MedicaidDE

Other names 1

  • Delawarr Dental Other name

National Provider Directory

National Provider Directory
Tax ID family
DVH Dental Suite131 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323129600000",
    "number": "1245302017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 FEDERAL ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013635",
            "telephone_number": "302-744-4554",
            "fax_number": "302-661-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 FEDERAL ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013635",
            "telephone_number": "302-744-4554",
            "fax_number": "302-661-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF DELAWARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2011-12-06",
        "status": "A",
        "authorized_official_last_name": "MCCLURE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DENTAL DIRECTOR",
        "authorized_official_telephone_number": "302-744-4554",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000086048",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delawarr Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.