NPIMap

Organization Active NPI

Mercy Dental Services

  • General Practice Dentistry
  • Canton, OH
National Provider Identifier
1700053576
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MERCY DENTAL SERVICES
Practice address
1320 Mercy Dr NW
2ND Floor - Surgery Center
Canton, OH 44708-2614
Phone
(330) 489-1000
Fax
(330) 471-5947
NPI assigned
May 12, 2008
Organization subpart
Yes
Parent organization
MERCY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Authorized official

Name
Michael C Holt
Title
Director of Finance
Phone
(330) 489-1268

Specialties & licenses 1

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

Addresses

Primary practice location

1320 Mercy Dr NW
2ND Floor - Surgery Center
Canton, OH 44708-2614

Mailing address

1320 Mercy Dr NW
2ND Floor - Surgery Center
Canton, OH 44708-2614
Phone (330) 489-1000

Other identifiers 1

IdentifierTypeStateIssuer
2690039MedicaidOH

Other names 1

  • Mercy Dental Services Other name

National Provider Directory

National Provider Directory
Tax ID family
Mercy Psychiatric Servi21 organizations share this tax ID, including this one
Part of
Mercy Psychiatric Servi

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Locations

1320 Mercy Dr NW
Fl 2
Canton, OH 44708
Phone (330) 489-1000

NPI Registry JSON

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1700053576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 MERCY DR NW",
            "address_2": "2ND FLOOR - SURGERY CENTER",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082614",
            "telephone_number": "330-489-1000",
            "fax_number": "330-471-5947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MERCY DR NW",
            "address_2": "2ND FLOOR - SURGERY CENTER",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082614",
            "telephone_number": "330-489-1000",
            "fax_number": "330-471-5947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY DENTAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY MEDICAL CENTER",
        "enumeration_date": "2008-05-12",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "330-489-1268"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2690039",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Dental Services",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Mercy Dental Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.