1730246000 NPI number — TERRENCE L. ALLEMANG, DDS INC.

Table of content: (NPI 1730246000)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730246000 NPI number — TERRENCE L. ALLEMANG, DDS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TERRENCE L. ALLEMANG, DDS INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730246000
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1487 W MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TIPP CITY
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45371-2803
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-667-0776
Provider Business Mailing Address Fax Number:
937-667-0854

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1487 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TIPP CITY
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45371-2803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-667-0776
Provider Business Practice Location Address Fax Number:
937-667-0854
Provider Enumeration Date:
01/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ALLEMANG
Authorized Official First Name:
TERRENCE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
937-667-0776

Provider Taxonomy Codes

  • Taxonomy code: 1223S0112X , with the licence number:  30016164 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000264404 . This is a "ABCBS PROVIDER #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2403296 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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