Provider Demographics
NPI:1013232271
Name:HEARTLAND DENTAL CARE OF OHIO,RICHARD E. WORKMAN, DMD, PC
Entity Type:Organization
Organization Name:HEARTLAND DENTAL CARE OF OHIO,RICHARD E. WORKMAN, DMD, PC
Other - Org Name:BADDOUR VILLEATE DENTAL SPA- WESTERVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE/CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:KAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-540-5100
Mailing Address - Street 1:135 HOFF RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8427
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:135 HOFF RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-8427
Practice Address - Country:US
Practice Address - Phone:614-882-5501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEARTLAND DENTAL CARE OF OHIO,RICHARD E. WORKMAN, DMD, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty