NPIMap

Organization Active NPI

Medved D.D.S. - Gardner D.D.S. Pickaway Dental Group LLC

Doing business as Pickaway General Dentistry

  • General Practice Dentistry
  • Circleville, OH
National Provider Identifier
1477887958
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30020068 Issued in OH
Legal business name
MEDVED D.D.S. - GARDNER D.D.S. PICKAWAY DENTAL GROUP LLC
Doing business as
Pickaway General Dentistry
Practice address
1422 Circleville Plaza Dr
Circleville, OH 43113-2269
Phone
(614) 530-6558
Fax
(614) 262-2883
NPI assigned
Sep 30, 2009
Last updated
Sep 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

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

Authorized official

Name
Dr. Robert W. Gardner, D.D.S.NPI 1295839470
Title
Partner/Member
Phone
(614) 530-6558

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30020074 OH
General Practice Dentistry 1223G0001X 30020068 OH Primary

Addresses

Primary practice location

1422 Circleville Plaza Dr
Circleville, OH 43113-2269

Mailing address

1422 Circleville Plaza Dr
Circleville, OH 43113-2269
Phone (614) 530-6558

Other identifiers 2

IdentifierTypeStateIssuer
0212577MedicaidOH
0978483MedicaidOH

Other names 1

  • Pickaway General Dentistry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254268800000",
    "number": "1477887958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 CIRCLEVILLE PLAZA DR",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "431132269",
            "telephone_number": "614-530-6558",
            "fax_number": "614-262-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 CIRCLEVILLE PLAZA DR",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "431132269",
            "telephone_number": "614-530-6558",
            "fax_number": "614-262-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDVED D.D.S. - GARDNER D.D.S. PICKAWAY DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-30",
        "last_updated": "2009-09-30",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PARTNER/MEMBER",
        "authorized_official_telephone_number": "614-530-6558",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30020074",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30020068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0212577",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0978483",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pickaway General Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Circleville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.