NPIMap

Organization Active NPI

Winchester Dental LLC

  • Dentist
  • Canal Winchester, OH
National Provider Identifier
1306216247
Registry record updated Oct 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30018271 Issued in OH
Legal business name
WINCHESTER DENTAL LLC
Practice address
6418 Winchester Blvd
Canal Winchester, OH 43110-2005
Phone
(614) 834-1834
NPI assigned
Oct 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2015

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

Authorized official

Name
Ladan Pourmoghadam, DDSNPI 1780885848
Title
Owner
Phone
(614) 506-0740

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 30018271 OH Primary

Addresses

Primary practice location

6418 Winchester Blvd
Canal Winchester, OH 43110-2005

Mailing address

6418 Winchester Blvd
Canal Winchester, OH 43110-2005

National Provider Directory

National Provider Directory

Locations

6418 Winchester Blvd
Canal Winchester, OH 43110
Phone (614) 496-4680

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": "1444003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444003200000",
    "number": "1306216247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6418 WINCHESTER BLVD",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431102005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6418 WINCHESTER BLVD",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431102005",
            "telephone_number": "614-834-1834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINCHESTER DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-05",
        "last_updated": "2015-10-05",
        "status": "A",
        "authorized_official_last_name": "POURMOGHADAM",
        "authorized_official_first_name": "LADAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-506-0740",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "30018271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canal Winchester, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.