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FAMILY DENTAL TEAM INC. NPI 1205008828


NPI Information

NPI: 1205008828
Provider Name: FAMILY DENTAL TEAM, INC.
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
620 RIDGEWOOD XING
SUITE K
FAIRLAWN, OH
ZIP 44333
Phone: (330) 376-9424
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FAMILY DENTAL TEAM, INC. is a general practice dentist in Fairlawn, OH. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. FAMILY DENTAL TEAM, INC. NPI is 1205008828. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

620 RIDGEWOOD XING
SUITE K
FAIRLAWN, OH
ZIP 44333-531
Phone: (330) 376-9424
Fax: (330) 376-2298

The provider's authorized official is James D George .
The authorized official title is President/owner and has the following contact phone number (330) 376-9424.

The enumeration date for this NPI number is 3/25/2008 and was last updated on 8/13/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice30-012228OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12531148MEDICAIDOHIO

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: 4/28/2024

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