Pediatric Dentistry of Central Ohio, Richard M. Loochtan DDS, Ms, LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

PEDIATRIC DENTISTRY OF CENTRAL OHIO, RICHARD M. LOOCHTAN DDS, MS, LLC

Practice address

1600 Cross Creeks Blvd
Pickerington, OH 43147

Phone

(614) 863-8500

Fax

(614) 863-0874

NPI assigned

Nov 24, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Richard M. Loochtan, D.D.S., M.S.

Title

Owner

Phone

(614) 863-8500

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394582400000",
    "number": "1801041405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 CROSS CREEKS BLVD",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "43147",
            "telephone_number": "614-863-8500",
            "fax_number": "614-863-0874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CROSS CREEKS BLVD",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "43147",
            "telephone_number": "614-863-8500",
            "fax_number": "614-863-0874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY OF CENTRAL OHIO, RICHARD M. LOOCHTAN DDS, MS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-24",
        "last_updated": "2014-03-12",
        "status": "A",
        "authorized_official_last_name": "LOOCHTAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-863-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OH",
            "license": "18880",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0819127OH",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; 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.