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UPPER ARLINGTON - BRYAN BASOM DDS LLC NPI 1013427921


NPI Information

NPI: 1013427921
Provider Name: UPPER ARLINGTON - BRYAN BASOM DDS LLC

Doing Business As: MAGNOLIA DENTAL

Classification: Dentist - 122300000X
Entity Type: Organization

CLIA Number: 36D0697856

Address:
1840 ZOLLINGER RD
COLUMBUS, OH
ZIP 43221
Phone: (614) 457-3927
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UPPER ARLINGTON - BRYAN BASOM DDS LLC is a dentist in Columbus, OH. The provider is a dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. UPPER ARLINGTON - BRYAN BASOM DDS LLC NPI is 1013427921. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Magnolia Dental.

The provider's business location address is:

1840 ZOLLINGER RD
COLUMBUS, OH
ZIP 43221-850
Phone: (614) 457-3927
Fax: (614) 457-0668

The provider's authorized official is Bryan Basom .
The authorized official title is Owner and has the following contact phone number (614) 406-7187.

The CLIA number assigned to this NPI record is 36D0697856 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/5/2017 and was last updated on 6/16/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1122300000XDentist30.022613OHIOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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