Dayton Dental Clinic Inc

Primary specialty

DentistTaxonomy code 122300000X

License

30016151 Issued in OH

Legal business name

DAYTON DENTAL CLINIC INC

Doing business as

Doc Family Dental

Practice address

1010 Woodman Dr
Dayton, OH 45432-1400

Phone

(937) 252-2000

Fax

(937) 252-1224

NPI assigned

May 23, 2007

Organization subpart

No

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

Authorized official

Name

Garima Gupta

Title

Credentialing Specialist

Phone

(937) 424-2215

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DOC FAMILY DENTAL Doing business as

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421798400000",
    "number": "1265642748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 WOODMAN DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454321400",
            "telephone_number": "937-252-2000",
            "fax_number": "937-252-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 WOODMAN DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454321400",
            "telephone_number": "937-252-2000",
            "fax_number": "937-252-1224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAYTON DENTAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2015-01-21",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "GARIMA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "937-424-2215"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "30016151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0692415",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOC FAMILY DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dayton Dental Collaborative
• Dayton Dental Group Yuchun Zhang DDS Inc (Dayton Dental Group)
• Dayton Dental Sleep Medicine LLC
• Dayton Endovascular Center, LLC
• Dayton Express Cab Com

• Dentist in Dayton, OH
• Providers in Dayton, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.