Ledgestone Dental - Meclosky DDS Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30018831 Issued in OH

Legal business name

LEDGESTONE DENTAL - MECLOSKY DDS INC

Practice address

18 Remick Blvd
Springboro, OH 45066-9168

Phone

(937) 748-9240

Fax

(937) 748-9626

NPI assigned

Apr 29, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Mark Allan Meclosky, DDS

Title

Owner

Phone

(937) 748-9240

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1760657811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 REMICK BLVD",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450669168",
            "telephone_number": "937-748-9240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 REMICK BLVD",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450669168",
            "telephone_number": "937-748-9240",
            "fax_number": "937-748-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEDGESTONE DENTAL - MECLOSKY DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "MECLOSKY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-748-9240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30018831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherene M Larue-Martin, AT, MPH
• Leo G Lasala, MD
• Jennifer Victoria Lawson, NP
• Karin Lynn Lawson, LPN
• Ledgestone Chiropractic and Wellness Center LLC
• Lifestyle Gardens LLC
• Lifestyle Gardens LLC
• Susan Amber Lincks, CDCA, LPN
• Holly Litteral
• Bobbi Lloyd

• General Practice Dentistry in Springboro, OH
• Providers in Springboro, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.