NPIMap

Organization Active NPI

Ohio Dental Professionals, Delisle, P.C.

  • General Practice Dentistry
  • Willoughby Hills, OH
National Provider Identifier
1851146583
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
OHIO DENTAL PROFESSIONALS, DELISLE, P.C.
Practice address
2770 Som Center Rd Ste 1
Willoughby Hills, OH 44094-9116
Phone
(440) 473-4746
NPI assigned
Apr 17, 2024
Organization subpart
Yes
Parent organization
OHIO DENTAL PROFESSIONALS, DELISLE, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Authorized official

Name
Hillary Thull
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2770 Som Center Rd Ste 1
Willoughby Hills, OH 44094-9116

Mailing address

2770 Som Center Rd Ste 1
Willoughby Hills, OH 44094-9116

Other names 1

  • Lake West Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of Oh Richard E Workman DMD PS39 organizations share this tax ID, including this one
Part of
Heartland Dental Care of Oh Richard E Workman DMD PS

Other organizations with this tax ID 38

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

View all 38

Locations

2770 Som Center Rd
Ste 1
Willoughby Hills, OH 44094
Phone (440) 473-4746

NPI Registry JSON

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1851146583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 SOM CENTER RD STE 1",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440949116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 SOM CENTER RD STE 1",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440949116",
            "telephone_number": "440-473-4746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO DENTAL PROFESSIONALS, DELISLE, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OHIO DENTAL PROFESSIONALS, DELISLE, P.C.",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake West Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willoughby Hills, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.