NPIMap

Organization Active NPI

W.J. Hagerty Dental Offices of Montgomery County, Inc

  • Dentist
  • Trotwood, OH
National Provider Identifier
1245325455
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30016938 Issued in OH
Legal business name
W.J. HAGERTY DENTAL OFFICES OF MONTGOMERY COUNTY, INC
Doing business as
Trotwood Family Dental
Practice address
321 N. Broadway
Trotwood, OH 45426
Phone
(937) 837-8412
Fax
(837) 854-3158
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Nevada D Endicott
Title
Business Manager
Phone
(937) 837-1888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 30016938 OH Primary

Addresses

Primary practice location

321 N. Broadway
Trotwood, OH 45426

Mailing address

321 N. Broadway
Trotwood, OH 45426
Phone (937) 837-8412

Other names 1

  • Trotwood Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

321 N Broadway St
Trotwood, OH 45426
Phone (937) 837-8412

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245325455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N. BROADWAY",
            "city": "TROTWOOD",
            "state": "OH",
            "postal_code": "45426",
            "telephone_number": "937-837-8412",
            "fax_number": "837-854-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N. BROADWAY",
            "city": "TROTWOOD",
            "state": "OH",
            "postal_code": "45426",
            "telephone_number": "937-837-8412",
            "fax_number": "837-854-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W.J. HAGERTY DENTAL OFFICES OF MONTGOMERY COUNTY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENDICOTT",
        "authorized_official_first_name": "NEVADA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "937-837-1888"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "30016938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trotwood Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Trotwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.