Angela D. Demoss, DMD Inc.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

30019818 Issued in OH

Legal business name

ANGELA D. DEMOSS, DMD INC.

Practice address

120 W Wenger Rd
Englewood, OH 45322-2762

Phone

(937) 836-1207

NPI assigned

Oct 14, 2010

Organization subpart

No

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

Authorized official

Name

Angela D Demoss, DMD

Title

President/Owner

Phone

(937) 836-1207

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287014400000",
    "number": "1740590645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W WENGER RD",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453222762",
            "telephone_number": "937-836-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W WENGER RD",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453222762",
            "telephone_number": "937-836-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELA D. DEMOSS, DMD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-14",
        "last_updated": "2010-10-14",
        "status": "A",
        "authorized_official_last_name": "DEMOSS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "937-836-1207",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30019818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1265571715",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; 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.