NPIMap

Organization Active NPI

Nisonger Dental Program at Johnstown Road

  • Dental Clinic/Center
  • Columbus, OH
National Provider Identifier
1265749899
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
71000178 Issued in OH
Legal business name
NISONGER DENTAL PROGRAM AT JOHNSTOWN ROAD
Practice address
2879 Johnstown Rd
Columbus, OH 43219-1719
Phone
(614) 342-5795
Fax
(614) 342-5804
NPI assigned
Sep 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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

Authorized official

Name
Dr. Diego Solis, DDSNPI 1902999303
Title
Clinic Director
Phone
(614) 342-5795

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 71000178 OH Primary

Addresses

Primary practice location

2879 Johnstown Rd
Columbus, OH 43219-1719

Mailing address

2879 Johnstown Rd
Columbus, OH 43219-1719
Phone (614) 342-5795

Other identifiers 1

IdentifierTypeStateIssuer
2671087MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Ohio State Univ Hosp11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2879 Johnstown Rd
Columbus, OH 43219
Phone (614) 342-5795

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283385600000",
    "number": "1265749899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2879 JOHNSTOWN RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432191719",
            "telephone_number": "614-342-5795",
            "fax_number": "614-342-5804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2879 JOHNSTOWN RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432191719",
            "telephone_number": "614-342-5795",
            "fax_number": "614-342-5804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NISONGER DENTAL PROGRAM AT JOHNSTOWN ROAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-02",
        "last_updated": "2010-09-02",
        "status": "A",
        "authorized_official_last_name": "SOLIS",
        "authorized_official_first_name": "DIEGO",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "614-342-5795",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OH",
            "license": "71000178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2671087",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; 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.