Moundbuilders General Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30 013925 Issued in OH

Legal business name

MOUNDBUILDERS GENERAL DENTISTRY

Practice address

1634 W Church St
Newark, OH 43055-1540

Phone

(740) 344-1810

Fax

(740) 344-0440

NPI assigned

Jul 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Richard Main, DDSNPI 1720191174

Title

Owner

Phone

(740) 344-1810

Specialties & licenses 1

Addresses

Other names 1

• Richard Main, DDS, Inc Other name

Locations

Practitioners 3

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

• Richard M Main, DDS

  • General Practice Dentistry
  • Newark, OH
  • NPI 1720191174
  NPD (past) Authorized official
• Benjamin Nathan Jump, DDS

  • General Practice Dentistry
  • Newark, OH
  • NPI 1215153796
  NPD (past)
• Jonah Staten, DDS

  • General Practice Dentistry
  • Newark, OH
  • NPI 1932588258
  NPD (past)

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184112000000",
    "number": "1295933281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 W CHURCH ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551540",
            "telephone_number": "740-344-1810",
            "fax_number": "740-344-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 W CHURCH ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551540",
            "telephone_number": "740-344-1810",
            "fax_number": "740-344-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNDBUILDERS GENERAL DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A",
        "authorized_official_last_name": "MAIN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-344-1810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30 013925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Richard Main, DDS, Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kelly Morrison, CNP
• Patricia Louise Morrison, APRN, BC
• Stephen Andrew Morrison, CDCA
• Cindy Jo Morrow, MA LPC
• Misty Shannon Mosholder
• Moundbuilders General Dentistry, DRS. Jump and Robertson LLC
• Moundbuilders Guidance Center
• Moundbuilders Guidance Center, Inc
• Moundview Obstetrics & Gynecology, Inc.
• Robert Woollen Mueller, MD

• General Practice Dentistry in Newark, OH
• Providers in Newark, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; 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.