Dentistry for Children of Ohio 2 Randy Hamilton DMD LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

DENTISTRY FOR CHILDREN OF OHIO 2 RANDY HAMILTON DMD LLC

Practice address

21590 Center Ridge Rd
Rocky River, OH 44116-3945

Phone

(770) 692-1000

NPI assigned

Jan 19, 2023

Last updated

Jun 28, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joann Rice

Title

Credentialing Manager

Phone

(609) 315-3851

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1659086049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2970 BRANDYWINE RD STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303415549",
            "telephone_number": "770-692-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21590 CENTER RIDGE RD",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163945",
            "telephone_number": "770-692-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTRY FOR CHILDREN OF OHIO 2 RANDY HAMILTON DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-19",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "JOANN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "609-315-3851"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Rocky River, OH
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.