NPIMap

Organization Active NPI

Dublin Kids Dental

  • Pediatric Dentistry
  • Dublin, OH
National Provider Identifier
1316336068
Registry record updated Jan 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
30.022533 Issued in OH
Legal business name
DUBLIN KIDS DENTAL
Practice address
6235 Perimeter Dr
Suite a
Dublin, OH 43017-7202
Phone
(310) 902-5927
NPI assigned
Jan 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2015

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

Authorized official

Name
Sophie (Yoon Mi) Matracia, DMD
Title
Pediatric Dentist, Owner
Phone
(310) 902-5927

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 30.022533 OH Primary

Addresses

Primary practice location

6235 Perimeter Dr
Suite a
Dublin, OH 43017-7202

Mailing address

6235 Perimeter Dr
Suite a
Dublin, OH 43017-7202
Phone (310) 902-5927

National Provider Directory

National Provider Directory

Locations

6235 Perimeter Dr
Ste A
Dublin, OH 43017
Phone (310) 902-5927

NPI Registry JSON

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

{
    "created_epoch": "1421625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421625600000",
    "number": "1316336068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6235 PERIMETER DR",
            "address_2": "SUITE A",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430177202",
            "telephone_number": "310-902-5927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6235 PERIMETER DR",
            "address_2": "SUITE A",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430177202",
            "telephone_number": "310-902-5927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBLIN KIDS DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-19",
        "last_updated": "2015-01-19",
        "status": "A",
        "authorized_official_last_name": "MATRACIA",
        "authorized_official_first_name": "SOPHIE (YOON MI)",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST, OWNER",
        "authorized_official_telephone_number": "310-902-5927",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.022533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.