Organization Active NPI

Chillicothe Family Dental Inc.

Doing business as Chillicothe Family Dental

  • General Practice Dentistry
  • Chillicothe, OH
National Provider Identifier
1407067234
Registry record updated Oct 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CHILLICOTHE FAMILY DENTAL INC.
Doing business as
Chillicothe Family Dental
Practice address
30 N. Walnut St.
Chillicothe, OH 45601
Phone
(740) 773-8384
Fax
(740) 773-0292
NPI assigned
May 24, 2007
Last updated
Oct 13, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2009

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

Authorized official

Name
Dr. Richard J Schoonmaker, DMD
Title
C.E.O.
Phone
(770) 773-8384

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

30 N. Walnut St.
Chillicothe, OH 45601

Mailing address

30 N. Walnut St.
Chillicothe, OH 45601
Phone (740) 773-8384

Other identifiers 1

IdentifierTypeStateIssuer
2505211MedicaidOH

Other names 1

  • Chillicothe Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

126 E 2nd St
Ste F
Chillicothe, OH 45601

30 N Walnut St
Chillicothe, OH 45601
Phone (740) 773-8384

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255392000000",
    "number": "1407067234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N. WALNUT ST.",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "45601",
            "telephone_number": "740-773-8384",
            "fax_number": "740-773-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N. WALNUT ST.",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "45601",
            "telephone_number": "740-773-8384",
            "fax_number": "740-773-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILLICOTHE FAMILY DENTAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2009-10-13",
        "status": "A",
        "authorized_official_last_name": "SCHOONMAKER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "770-773-8384",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2505211",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chillicothe Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chillicothe, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2009; 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.