Professional Dental Alliance of Chillicothe, LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

PROFESSIONAL DENTAL ALLIANCE OF CHILLICOTHE, LLC

Practice address

1849 N Bridge St
Chillicothe, OH 45601-4110

Phone

(740) 773-2222

NPI assigned

Jul 30, 2019

Organization subpart

No

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

Authorized official

Name

Lauren Howard

Title

Credentialing Specialist

Phone

(757) 576-5479

Specialties & licenses 1

Addresses

Tax ID family

Professional Dental Alliance of Chillicothe LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Professional Dental Alliance of Chillicothe, LLC

  • Dentist
  • Chillicothe, OH
  • NPI 1962974709
  NPD tax ID

Locations

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

{
    "created_epoch": "1564444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564444800000",
    "number": "1831743798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 S MILL ST STE 200",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161013680",
            "telephone_number": "757-576-5479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 N BRIDGE ST",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456014110",
            "telephone_number": "740-773-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE OF CHILLICOTHE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-30",
        "last_updated": "2019-07-30",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "757-576-5479"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Pridemore, CDCA, QBHS
• Priority Dental Inc
• Procare Vision Center of Chillicothe
• Julie Kay Proctor
• Angie Lee Proehl, RN
• Professional Dental Alliance of Chillicothe, LLC
• Proscan Imaging of Chillicothe, LLC
• Charles Adam Pruitt, PSY.D.
• April Dawn Pryor, LPN
• Michael David Pugh, R.PH., BCOP

• Oral and Maxillofacial Surgery (Dentist) in Chillicothe, OH
• Providers in Chillicothe, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; 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.