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Contact Information

555 W ELM ST DENTISTRY LLC
555 W ELM ST
LIMA, OH45801-4757
 Phone: 419-229-0776
 Fax: 419-229-3828
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for 555 W ELM ST DENTISTRY LLC

NPI Number 1043351034
LBN Legal business name 555 W ELM ST DENTISTRY LLC
Authorized official DAVID HANCOCK - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/10/2007
Last updated 03/19/2008 - About 18 years ago
Identifiers
OH License # 30 . 20842
OH Medicaid 2081376
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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