Centerville Dental Center Ohio LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CENTERVILLE DENTAL CENTER OHIO LLC

Practice address

9346 Dayton Lebanon Pike
Centerville, OH 45458-3839

Phone

(937) 435-4150

NPI assigned

Feb 25, 2019

Last updated

Jul 20, 2022By 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

Opal Anderson

Title

Coo

Phone

(937) 435-4150

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1427515667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9346 DAYTON LEBANON PIKE",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454583839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9346 DAYTON LEBANON PIKE",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454583839",
            "telephone_number": "937-435-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERVILLE DENTAL CENTER OHIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-25",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "OPAL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "937-435-4150"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@centervilledentalcenter.com",
            "affiliation": "N",
            "address_1": "9346 Dayton Lebanon Pike",
            "city": "Centerville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454583839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Angela Carson, LMT
• Matthew John Cavo, M.D.
• Monica Ann Cengia, RD LD
• Centerille Pediatric Dentistry, Kyle R Jackson, DDS, Inc
• Centerville Chiropractic I (Centerville Chiropractic)
• Centerville Family Eye Care
• Centerville Hearing Center, LLC
• Centerville Oh - Kyle Jackson DDS Inc
• Centerville Podiatry Inc
• Centerville SNF Healthcare LLC (Centerville Post Acute)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.