NPIMap

Organization Active NPI

Complete Dental Care of Shadyside

  • Dentist
  • Shadyside, OH
National Provider Identifier
1609323831
Registry record updated Sep 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.023979 Issued in OH
Legal business name
COMPLETE DENTAL CARE OF SHADYSIDE
Practice address
3775 Central Ave
Shadyside, OH 43947-1344
Phone
(740) 676-2604
Fax
(740) 676-2604
NPI assigned
Sep 6, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2016

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

Authorized official

Name
Armanda Lester
Title
Office Manager
Phone
(740) 485-0309

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 30.023979 OH Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 30.016390 OH
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 30.024551 OH
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 30.24884 OH

Addresses

Primary practice location

3775 Central Ave
Shadyside, OH 43947-1344

Mailing address

2700 Sunset Blvd
Steubenville, OH 43952-1158
Phone (740) 264-6811

National Provider Directory

National Provider Directory

Locations

3775 Central Ave
Shadyside, OH 43947
Phone (740) 676-2604

Practitioners & affiliated clinicians

Practitioners 2

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": "1473120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473120000000",
    "number": "1609323831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 SUNSET BLVD",
            "city": "STEUBENVILLE",
            "state": "OH",
            "postal_code": "439521158",
            "telephone_number": "740-264-6811",
            "fax_number": "740-264-6812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 CENTRAL AVE",
            "city": "SHADYSIDE",
            "state": "OH",
            "postal_code": "439471344",
            "telephone_number": "740-676-2604",
            "fax_number": "740-676-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE DENTAL CARE OF SHADYSIDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-06",
        "last_updated": "2016-09-06",
        "status": "A",
        "authorized_official_last_name": "LESTER",
        "authorized_official_first_name": "ARMANDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "740-485-0309"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.023979",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.016390",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.024551",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.24884",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shadyside, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; 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.