Phillip T Latham, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30013309 Issued in OH

Practice address

4488 W Broad St
Columbus, OH 43228-5610

Phone

(614) 878-7778

Fax

(614) 878-2725

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1437215308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4488 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432285610",
            "telephone_number": "614-878-7778",
            "fax_number": "614-878-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4488 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432285610",
            "telephone_number": "614-878-7778",
            "fax_number": "614-878-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "PHILLIP",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30013309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0417794",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000116964",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latasha Sarr
• Anika Latelle, LISW-S
• Benjamin Seth Latelle
• Caitlin Latham
• Donmonique Lashell Latham
• Jason David Lather, MD
• Patricia A Lathrop, PHD
• Sam M Latif, DMD
• Dae'Vontay Latimer
• Dorian Latimore

• Oral and Maxillofacial Surgery (Dentist) in Columbus, OH
• Providers in Columbus, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.