Active NPI
Courtney Maynard, DDS
- Pediatric Dentistry
- Springfield, OH
National Provider Identifier
1659994804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 30.026190
- Practice address
- 2200 Olympic St
Springfield, OH 45503-2858 - Phone
- (937) 390-0493
- NPI assigned
- May 22, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | 30.026190 | OH | |
| Pediatric Dentistry | 1223P0221X | 30.026190 | OH | Primary |
Addresses
Primary practice location
2200 Olympic St
Springfield, OH 45503-2858
Mailing address
5828 Wynnewood Dr
Grove City, OH 43123-3584
Other practice location 1
University Hospitals Cleveland Medical Center
11100 Euclid Ave
Cleveland, OH 44106
Phone (216) 844-1000
Other practice location 2
1897 Ohio Dr
Grove City, OH 43123-4839
Phone (614) 871-3700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.026190 | OH | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756080000000",
"number": "1659994804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5828 WYNNEWOOD DR",
"city": "GROVE CITY",
"state": "OH",
"postal_code": "431233584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 OLYMPIC ST",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455032858",
"telephone_number": "937-390-0493"
}
],
"practiceLocations": [
{
"address_1": "University Hospitals Cleveland Medical Center",
"address_2": "11100 Euclid Ave",
"address_purpose": "LOCATION",
"city": "Cleveland",
"state": "OH",
"postal_code": "44106",
"country_code": "US",
"telephone_number": "216-844-1000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1897 Ohio Dr",
"address_purpose": "LOCATION",
"city": "Grove City",
"state": "OH",
"postal_code": "431234839",
"country_code": "US",
"telephone_number": "614-871-3700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAYNARD",
"first_name": "COURTNEY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-22",
"last_updated": "2025-08-25",
"certification_date": "2025-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "OH",
"license": "30.026190",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "OH",
"license": "30.026190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.