Hamilton Riverside Dentistry LLC

Primary specialty

DentistTaxonomy code 122300000X

License

30019324 Issued in OH

Legal business name

HAMILTON RIVERSIDE DENTISTRY LLC

Practice address

112 N. Second St
Hamilton, OH 45011

Phone

(513) 868-0200

NPI assigned

Jul 15, 2014

Last updated

Dec 8, 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

David T Tankovich

Title

Operations Director

Phone

(513) 868-0200

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1356758015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 N 2ND ST",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450112702",
            "telephone_number": "513-868-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 N. SECOND ST",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "45011",
            "telephone_number": "513-868-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMILTON RIVERSIDE DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-15",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "TANKOVICH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "513-868-0200"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "30019324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0106920",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kate Hamilton
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• Beverly Ann Hamman

• Dentist in Hamilton, OH
• Providers in Hamilton, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.