NPIMap

Organization Active NPI

Dayton VA Medican Center

  • General Practice Dentistry
  • Dayton, OH
National Provider Identifier
1669855144
Registry record updated Jul 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
RES.3597 Issued in OH
Legal business name
DAYTON VA MEDICAN CENTER
Practice address
4100 W 3Rd St
Dayton Vamc Dental Services (160)
Dayton, OH 45428-9000
Phone
(937) 262-2102
NPI assigned
Jul 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2015

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

Authorized official

Name
Dr. David Stanczyk, DDS
Title
Authorized Official
Phone
(937) 262-2102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X RES.3597 OH Primary

Addresses

Primary practice location

4100 W 3Rd St
Dayton Vamc Dental Services (160)
Dayton, OH 45428-9000

Mailing address

4100 W 3Rd St
Dayton Vamc Dental Services (160)
Dayton, OH 45428-9000
Phone (937) 262-2102

National Provider Directory

National Provider Directory
Tax ID family
McDonald Army Health Care Center200 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 7

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

4100 W 3rd St
#160
Dayton, OH 45428
Phone (937) 262-2102

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": "1435795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435795200000",
    "number": "1669855144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 W 3RD ST",
            "address_2": "DAYTON VAMC DENTAL SERVICES (160)",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454289000",
            "telephone_number": "937-262-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W 3RD ST",
            "address_2": "DAYTON VAMC DENTAL SERVICES (160)",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454289000",
            "telephone_number": "937-262-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAYTON VA MEDICAN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-02",
        "last_updated": "2015-07-02",
        "status": "A",
        "authorized_official_last_name": "STANCZYK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "937-262-2102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "RES.3597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; 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.