NPIMap

Organization Active NPI

Keith a Wing DDS & Matthew P Mack Christopher R Smith DDS Inc

  • General Practice Dentistry
  • Newark, OH
National Provider Identifier
1376948836
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30 021474 Issued in OH
Legal business name
KEITH A WING DDS & MATTHEW P MACK CHRISTOPHER R SMITH DDS INC
Practice address
1420 Dickerson St
Newark, OH 43055-1844
Phone
(740) 344-9155
Fax
(740) 344-5668
NPI assigned
Oct 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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

Authorized official

Name
Matthew Mack, DDSNPI 1629289541
Title
Dentist/ Owner
Phone
(740) 344-9155

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 30 021474 OH Primary

Addresses

Primary practice location

1420 Dickerson St
Newark, OH 43055-1844

Mailing address

1420 Dickerson St
Newark, OH 43055-1844
Phone (740) 344-9155

Other names 1

  • Wing, Mack & Smith DDS, Inc Doing business as

National Provider Directory

National Provider Directory

Locations

1420 Dickerson St
Newark, OH 43055
Phone (740) 344-9155

Practitioners & affiliated clinicians

Practitioners 2

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": "1414368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414713600000",
    "number": "1376948836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 DICKERSON ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551844",
            "telephone_number": "740-344-9155",
            "fax_number": "740-344-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 DICKERSON ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551844",
            "telephone_number": "740-344-9155",
            "fax_number": "740-344-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH A WING DDS & MATTHEW P MACK CHRISTOPHER R SMITH DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-27",
        "last_updated": "2014-10-31",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "DENTIST/ OWNER",
        "authorized_official_telephone_number": "740-344-9155",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30 021474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wing, Mack & Smith DDS, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.