NPIMap

Organization Active NPI

Ollom Community Dental, LLC

  • Dental Clinic/Center
  • Lima, OH
National Provider Identifier
1871067504
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
OLLOM COMMUNITY DENTAL, LLC
Practice address
1702 Allentown Rd
Lima, OH 45805-1845
Phone
(419) 222-0693
NPI assigned
Jan 16, 2019
Last updated
Nov 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Authorized official

Name
Jane Ann Campbell
Title
Director of Operations
Phone
(419) 228-4036

Specialties & licenses 1

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

Addresses

Primary practice location

1702 Allentown Rd
Lima, OH 45805-1845

Mailing address

1702 Allentown Rd
Lima, OH 45805-1845
Phone (419) 222-0693

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Lima
CONNECT URL Lima

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1547596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606694400000",
    "number": "1871067504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 ALLENTOWN RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458051845",
            "telephone_number": "419-222-0693",
            "fax_number": "419-879-6478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 ALLENTOWN RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458051845",
            "telephone_number": "419-222-0693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLLOM COMMUNITY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-16",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "419-228-4036"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Lima",
            "affiliation": "N",
            "address_1": "1702 Allentown Rd",
            "city": "Lima",
            "state": "OH",
            "country_code": "US",
            "postal_code": "458051845",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Lima",
            "affiliation": "N",
            "address_1": "1702 Allentown Rd",
            "city": "Lima",
            "state": "OH",
            "country_code": "US",
            "postal_code": "458051845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.