Portage Dental Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PORTAGE DENTAL CENTER

Practice address

250 S Chestnut St Ste 30
Ravenna, OH 44266-3031

Phone

(330) 297-7009

Fax

(330) 297-0901

NPI assigned

Jan 26, 2007

Last updated

Feb 19, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Ann Harry

Title

Office Administrator MGR

Phone

(330) 297-7009

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392768000000",
    "number": "1316093024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S CHESTNUT ST STE 30",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663031",
            "telephone_number": "330-297-7009",
            "fax_number": "330-297-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S CHESTNUT ST STE 30",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663031",
            "telephone_number": "330-297-7009",
            "fax_number": "330-297-0901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTAGE DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2014-02-19",
        "status": "A",
        "authorized_official_last_name": "HARRY",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR MGR",
        "authorized_official_telephone_number": "330-297-7009",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0468597",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Portage County Children's Services Center (Children's Advantage)
• Portage County Children's Services Center (Children's Advantage)
• Portage County Combined General Health District
• Portage County Educational Service Center
• Portage County Esc
• Portage Dental Group, Jeffrey S. Rosenthal D.D.S., Inc.
• Portage Foot Health, Inc.
• Portage Industries, Inc.
• Portage Pathology Associates, Inc
• Portage Physical Therapists ,Inc (Allied Health Rehab Center)

• General Practice Dentistry in Ravenna, OH
• Providers in Ravenna, 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 Feb 19, 2014; 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.