Hyde Park Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

30.023390 Issued in OH

Legal business name

HYDE PARK PEDIATRIC DENTISTRY

Practice address

3870 Paxton Ave
Suite G and H
Cincinnati, OH 45209-2366

Phone

(513) 979-6998

Fax

(513) 979-6990

NPI assigned

Feb 2, 2012

Last updated

Feb 2, 2012By 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

Katlin BlomerNPI 1114153343

Title

Owner/Dentist

Phone

(513) 979-6998

Specialties & licenses 1

Addresses

Tax ID family

Hyde Park Pediatric Dentistry2 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.

• Katlin Allen Bloomer DMD Inc

  dba Hyde Park Pediatric Dentistry

  • Pediatric Dentistry
  • Cincinnati, OH
  • NPI 1730962770
  NPD tax ID

Locations

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.

• Katlin Blomer, D.M.D.

  • Pediatric Dentistry
  • Cincinnati, OH
  • NPI 1114153343
  NPD (past) Authorized official

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328140800000",
    "number": "1659643922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3870 PAXTON AVE",
            "address_2": "SUITE G AND H",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452092366",
            "telephone_number": "513-979-6998",
            "fax_number": "513-979-6990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3870 PAXTON AVE",
            "address_2": "SUITE G AND H",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452092366",
            "telephone_number": "513-979-6998",
            "fax_number": "513-979-6990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDE PARK PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-02",
        "last_updated": "2012-02-02",
        "status": "A",
        "authorized_official_last_name": "BLOMER",
        "authorized_official_first_name": "KATLIN",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "513-979-6998"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.023390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamara Hyatt, DO
• Hyde Park Counseling Professionals
• Hyde Park Counseling Professionals
• Hyde Park Medical Associates, Inc.
• Hyde Park Optometrists, Inc.
• Hyde Park Pediatrics, Inc
• Hyde Park Physical Medicine, Inc. (Kenwood Rehabilitation)
• Hyde Park Thyroid and Endocrine LLC
• Emmanuella Hyde-Napoleon
• Kelli Marie Hyde, MSW, BCBA, COBA

• Pediatric Dentistry in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Pediatric Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; 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.