NPIMap

Organization Active NPI

Kalniz Dental-Maumee, LLC

  • General Practice Dentistry
  • Maumee, OH
National Provider Identifier
1508040494
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-MULTIPLE Issued in OH
Legal business name
KALNIZ DENTAL-MAUMEE, LLC
Practice address
447 W Dussel Dr
Maumee, OH 43537-4208
Phone
(419) 536-7265
NPI assigned
Dec 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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

Authorized official

Name
Dr. Scott Bryan Kalniz, DDS
Title
President
Phone
(419) 536-7265

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 30-MULTIPLE OH Primary

Addresses

Primary practice location

447 W Dussel Dr
Maumee, OH 43537-4208

Mailing address

1642 Ralston Cir
Toledo, OH 43615-3801
Phone (419) 536-7265

Other identifiers 1

IdentifierTypeStateIssuer
447 W DUSSEL DRIVEOtherOH447 W DUSSEL DRIVE MAUMEE OH 43537

Other names 1

  • Reynolds Corners Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kalniz Dental - Maumee LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

447 W Dussel Dr
Maumee, OH 43537
Phone (419) 536-7265

1642 Ralston Cir
Toledo, OH 43615
Phone (419) 536-7265

Practitioners & affiliated clinicians

Practitioners 3

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": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1508040494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1642 RALSTON CIR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436153801",
            "telephone_number": "419-536-7265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 W DUSSEL DR",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435374208",
            "telephone_number": "419-536-7265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALNIZ DENTAL-MAUMEE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "KALNIZ",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-536-7265",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-MULTIPLE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "447 W DUSSEL DRIVE MAUMEE OH 43537",
            "identifier": "447 W DUSSEL DRIVE",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reynolds Corners Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.