Provider Demographics
NPI:1245634443
Name:DENTAL SERVICES OF OHIO, JAMES G. TURK, DDS, AND CHRIS KANG, DMD, INC.
Entity type:Organization
Organization Name:DENTAL SERVICES OF OHIO, JAMES G. TURK, DDS, AND CHRIS KANG, DMD, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF COMPLIANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLEE
Authorized Official - Middle Name:ANDREA
Authorized Official - Last Name:MERTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-428-1674
Mailing Address - Street 1:PO BOX 11568
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66207-4268
Mailing Address - Country:US
Mailing Address - Phone:913-428-1670
Mailing Address - Fax:913-800-6967
Practice Address - Street 1:4324 TUSCARAWAS ST W
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-5427
Practice Address - Country:US
Practice Address - Phone:913-428-1670
Practice Address - Fax:913-800-6967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2817349Medicaid