NPIMap

Organization Active NPI

Family Dental Care at Eagleton Center

  • Dental Clinic/Center
  • London, OH
National Provider Identifier
1811170160
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
FAMILY DENTAL CARE AT EAGLETON CENTER
Practice address
391 Lafayette St.
London, OH 43140-9195
Phone
(740) 852-7741
Fax
(740) 852-7783
NPI assigned
Dec 10, 2007
Last updated
Mar 30, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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

Authorized official

Name
Dr. Ali Khaksafard, DDS
Title
Owner
Phone
(740) 852-7741

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

391 Lafayette St.
London, OH 43140-9195

Mailing address

391 Lafayette St
London, OH 43140-9326
Phone (740) 852-7741

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490832000000",
    "number": "1811170160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 LAFAYETTE ST",
            "city": "LONDON",
            "state": "OH",
            "postal_code": "431409326",
            "telephone_number": "740-852-7741",
            "fax_number": "740-852-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 LAFAYETTE ST.",
            "city": "LONDON",
            "state": "OH",
            "postal_code": "431409195",
            "telephone_number": "740-852-7741",
            "fax_number": "740-852-7783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL CARE AT EAGLETON CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-10",
        "last_updated": "2017-03-30",
        "status": "A",
        "authorized_official_last_name": "KHAKSAFARD",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-852-7741",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in London, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; 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.