NPIMap

Organization Active NPI

Noonan, Brockman and Pollock, D.D.S., Inc.

  • Pediatric Dentistry
  • Middletown, OH
National Provider Identifier
1689754327
Registry record updated May 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
13948 Issued in OH
Legal business name
NOONAN, BROCKMAN AND POLLOCK, D.D.S., INC.
Practice address
210 S Breiel Blvd
Middletown, OH 45044-5157
Phone
(513) 423-9239
Fax
(513) 423-4188
NPI assigned
Oct 17, 2006
Last updated
May 7, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2019

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

Authorized official

Name
Aimee Corwin
Title
Accounts Manager
Phone
(513) 423-9239

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 13948 OH Primary

Addresses

Primary practice location

210 S Breiel Blvd
Middletown, OH 45044-5157

Mailing address

210 S Breiel Blvd
Middletown, OH 45044-5157
Phone (513) 423-9239

Other identifiers 4

IdentifierTypeStateIssuer
0743637MedicaidOH
2705826MedicaidOH
0184072MedicaidOH
0701379MedicaidOH

Other names 1

  • Noonan and Brockman, D.D.S., Inc. Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557187200000",
    "number": "1689754327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S BREIEL BLVD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450445157",
            "telephone_number": "513-423-9239",
            "fax_number": "513-423-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S BREIEL BLVD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450445157",
            "telephone_number": "513-423-9239",
            "fax_number": "513-423-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOONAN, BROCKMAN AND POLLOCK, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2019-05-07",
        "status": "A",
        "authorized_official_last_name": "CORWIN",
        "authorized_official_first_name": "AIMEE",
        "authorized_official_title_or_position": "ACCOUNTS MANAGER",
        "authorized_official_telephone_number": "513-423-9239"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "13948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0743637",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2705826",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0184072",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0701379",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Noonan and Brockman, D.D.S., Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Middletown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; 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.