1790939239 NPI number — ELLIOT P. SCHLANG, DDS, OHIO, INC.

Table of content: (NPI 1790939239)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790939239 NPI number — ELLIOT P. SCHLANG, DDS, OHIO, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ELLIOT P. SCHLANG, DDS, OHIO, 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:
1790939239
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
33533 W 12 MILE RD
Provider Second Line Business Mailing Address:
SUITE 150
Provider Business Mailing Address City Name:
FARMINGTON HILLS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48331-3354
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-833-8441
Provider Business Mailing Address Fax Number:
888-330-4331

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3726 W. CENTRAL AVE.
Provider Second Line Business Practice Location Address:
SUITE M#111
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43617
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-833-8441
Provider Business Practice Location Address Fax Number:
888-330-4331
Provider Enumeration Date:
11/11/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SCHLANG
Authorized Official First Name:
ELLIOT
Authorized Official Middle Name:
P.
Authorized Official Title or Position:
DENTAL DIRECTOR
Authorized Official Telephone Number:
888-833-8441

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  30-022902 , 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)





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