Ollom DDS Tipp City LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

OLLOM DDS TIPP CITY LLC

Doing business as

Pure Smiles Tipp City

Practice address

110 S Tippecanoe Dr
Tipp City, OH 45371-3104

Phone

(937) 667-2417

NPI assigned

May 6, 2019

Organization subpart

Yes

Parent organization

OLLOM ENTERPRISES LLCAs reported in NPPES

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

Authorized official

Name

Mrs. Bobbe Campbell

Title

Director of Operations

Phone

(937) 667-2417

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pure Smiles Tipp City Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634688000000",
    "number": "1750946794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 ALLENTOWN RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458051749",
            "telephone_number": "419-228-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S TIPPECANOE DR",
            "city": "TIPP CITY",
            "state": "OH",
            "postal_code": "453713104",
            "telephone_number": "937-667-2417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLLOM DDS TIPP CITY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OLLOM ENTERPRISES LLC",
        "enumeration_date": "2019-05-06",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "BOBBE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "937-667-2417",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1366754723",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mail@healthparkdentistry.com",
            "affiliation": "N",
            "address_1": "110 S Tippecanoe Dr",
            "city": "Tipp City",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453713104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Pure Smiles Tipp City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Tipp City, OH
• Providers in Tipp City, OH by specialty
• Dental Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.