NPIMap

Organization Active NPI

Ohio Dental Professionals, Delisle, P.C.

Doing business as Family Dental Care of Medina

  • General Practice Dentistry
  • Medina, OH
National Provider Identifier
1407232218
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
OHIO DENTAL PROFESSIONALS, DELISLE, P.C.
Doing business as
Family Dental Care of Medina
Practice address
890 N Court St
Medina, OH 44256-1719
Phone
(330) 591-9934
NPI assigned
Aug 4, 2015
Last updated
Aug 4, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
OHIO DENTAL PROFESSIONALS, DELISLE, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Authorized official

Name
Carmen Woods
Title
Credentialing
Phone
(217) 540-5100

Specialties & licenses 1

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

Addresses

Primary practice location

890 N Court St
Medina, OH 44256-1719

Mailing address

890 N Court St
Medina, OH 44256-1719

Other names 1

  • Family Dental Care of Medina Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of Ohiorichard E Workman DMD PC39 organizations share this tax ID, including this one
Part of
Heartland Dental Care of Ohiorichard E Workman DMD PC

Other organizations with this tax ID 38

Organizations that report the same tax identification number in the National Provider Directory.

View all 38

Locations

890 N Court St
Medina, OH 44256
Phone (330) 359-1486

NPI Registry JSON

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438646400000",
    "number": "1407232218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 N COURT ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442561719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 N COURT ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442561719",
            "telephone_number": "330-591-9934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO DENTAL PROFESSIONALS, DELISLE, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OHIO DENTAL PROFESSIONALS, DELISLE, P.C.",
        "enumeration_date": "2015-08-04",
        "last_updated": "2015-08-04",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dental Care of Medina",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.