J Clarke Sanders DDS-Centerville LLC

Primary specialty

DentistTaxonomy code 122300000X

License

17563 Issued in OH

Legal business name

J CLARKE SANDERS DDS-CENTERVILLE LLC

Doing business as

Centerville Family Dental

Practice address

9420 Lebanon Pike
Centerville, OH 45458-3860

Phone

(937) 433-8900

Fax

(937) 433-8905

NPI assigned

Sep 4, 2009

Organization subpart

No

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

Authorized official

Name

Dr. John Clarke Sanders, D.D.S.

Title

Owner

Phone

(614) 864-3196

Specialties & licenses 1

Addresses

Other names 1

• CENTERVILLE FAMILY DENTAL Doing business as

Locations

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

{
    "created_epoch": "1252022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252022400000",
    "number": "1659504884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9420 LEBANON PIKE",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454583860",
            "telephone_number": "937-433-8900",
            "fax_number": "937-433-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9420 LEBANON PIKE",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454583860",
            "telephone_number": "937-433-8900",
            "fax_number": "937-433-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J CLARKE SANDERS DDS-CENTERVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-04",
        "last_updated": "2009-09-04",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CLARKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-864-3196",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "17563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTERVILLE FAMILY DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Centerville, OH
• Providers in Centerville, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.