Organization Active NPI

Meckler Dental Providers (Willoughby), Inc.

Doing business as DentalWorks of Willoughby

  • General Practice Dentistry
  • Willoughby, OH
National Provider Identifier
1477921674
Registry record updated Mar 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MECKLER DENTAL PROVIDERS (WILLOUGHBY), INC.
Doing business as
DentalWorks of Willoughby
Practice address
36173 Euclid Ave
Willoughby, OH 44094-4410
Phone
(440) 946-0640
Fax
(216) 584-1085
NPI assigned
Sep 4, 2015
Organization subpart
Yes
Parent organization
DENTALONE PARTNERS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 20, 2018

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

Authorized official

Name
Rachel Nittinger
Title
Manager Credentialing
Phone
(972) 755-0816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

36173 Euclid Ave
Willoughby, OH 44094-4410

Mailing address

7160 Dallas Pkwy Ste 400
Plano, TX 75024-7111

Other names 1

  • DentalWorks of Willoughby Doing business as

National Provider Directory

National Provider Directory

Locations

36173 Euclid Ave
Willoughby, OH 44094
Phone (440) 255-5631

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": "1441324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521504000000",
    "number": "1477921674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7160 DALLAS PKWY STE 400",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750247111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36173 EUCLID AVE",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944410",
            "telephone_number": "440-946-0640",
            "fax_number": "216-584-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECKLER DENTAL PROVIDERS (WILLOUGHBY), INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTALONE PARTNERS, INC",
        "enumeration_date": "2015-09-04",
        "last_updated": "2018-03-20",
        "status": "A",
        "authorized_official_last_name": "NITTINGER",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "MANAGER CREDENTIALING",
        "authorized_official_telephone_number": "972-755-0816"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DentalWorks of Willoughby",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willoughby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; 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.