TLC Dental Center LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30-022153 Issued in OH

Legal business name

TLC DENTAL CENTER LLC

Practice address

1127 W 5TH St
Marysville, OH 43040-9282

Phone

(937) 642-2400

Fax

(937) 642-2490

NPI assigned

May 19, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Hae Su Yim, D.M.D.NPI 1285848218

Title

Owner, Dentist

Phone

(937) 642-2400

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hae Su Yim, D.M.D.

  • General Practice Dentistry
  • Marysville, OH
  • NPI 1285848218
  NPD (past) Authorized official

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1942467808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 W 5TH ST",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430409282",
            "telephone_number": "937-642-2400",
            "fax_number": "937-642-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 W 5TH ST",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430409282",
            "telephone_number": "937-642-2400",
            "fax_number": "937-642-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC DENTAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "YIM",
        "authorized_official_first_name": "HAE SU",
        "authorized_official_title_or_position": "OWNER, DENTIST",
        "authorized_official_telephone_number": "937-642-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-022153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA HEALTHCARE OF OHIO",
            "identifier": "179363 - LOCATION #",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2572470",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sudha Swamy Thompson, MD
• Teresa Thompson, PTA
• Kimberly Lynn Thorley, CNP
• Sara Tillman, LISW-S
• Eliza Tivnan, MOTR/L
• Chelsea M Toops, M.A., CCC-SLP
• Township of Allen
• Tranquility Acupuncture, LLC
• Victor A Trianfo, DO
• Daniel Trickett

• General Practice Dentistry in Marysville, OH
• Providers in Marysville, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.