NPIMap

Organization Active NPI

Bowling Green Pediatric Dental Group Inc

  • Pediatric Dentistry
  • Bowling Green, OH
National Provider Identifier
1477611333
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
30014316 Issued in OH
Legal business name
BOWLING GREEN PEDIATRIC DENTAL GROUP INC
Practice address
1221 Ridgewood Drive
Suite B
Bowling Green, OH 43402-2667
Phone
(419) 352-2593
Fax
(419) 354-4717
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Frank Louis Pace, DDSNPI 1003974965
Title
President
Phone
(419) 352-2593

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
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 30014316 OH Primary

Addresses

Primary practice location

1221 Ridgewood Drive
Suite B
Bowling Green, OH 43402-2667

Mailing address

1221 Ridgewood Drive
Suite B
Bowling Green, OH 43402-2667
Phone (419) 352-2593

Other identifiers 1

IdentifierTypeStateIssuer
0587262MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477611333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 RIDGEWOOD DRIVE",
            "address_2": "SUITE B",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434022667",
            "telephone_number": "419-352-2593",
            "fax_number": "419-354-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 RIDGEWOOD DRIVE",
            "address_2": "SUITE B",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434022667",
            "telephone_number": "419-352-2593",
            "fax_number": "419-354-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOWLING GREEN PEDIATRIC DENTAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PACE",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-352-2593",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30014316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0587262",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.