Organization Active NPI

G Scott Louderback DDS LLC

  • Dentist
  • Oregon, OH
National Provider Identifier
1285909184
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
G SCOTT LOUDERBACK DDS LLC
Practice address
631 S Wheeling St
Oregon, OH 43616-2742
Phone
(419) 693-1234
NPI assigned
Mar 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

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

Authorized official

Name
Dr. Gary S Louderback, DDS
Title
Owner
Phone
(419) 693-1234

Specialties & licenses 1

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

Addresses

Primary practice location

631 S Wheeling St
Oregon, OH 43616-2742

Mailing address

631 S Wheeling St
Oregon, OH 43616-2742
Phone (419) 693-1234

Other identifiers 1

IdentifierTypeStateIssuer
1316100167OtherOHINDIVIDUAL NPI NUMBER

National Provider Directory

National Provider Directory

Locations

631 S Wheeling St
Oregon, OH 43616
Phone (419) 693-1234

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331510400000",
    "number": "1285909184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 S WHEELING ST",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436162742",
            "telephone_number": "419-693-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 S WHEELING ST",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436162742",
            "telephone_number": "419-693-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G SCOTT LOUDERBACK DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-12",
        "last_updated": "2012-03-12",
        "status": "A",
        "authorized_official_last_name": "LOUDERBACK",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-693-1234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1316100167",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; 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.