CASEY M. SLACK (NPI# 1477873040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477873040 |
| Entity Type | Individual |
| Full Name | CASEY M. SLACK |
| Credential | DDS |
| Practice Address |
4881 Sugar Maple Dr Dayton OH 45433 |
| Mailing Address |
4881 Sugar Maple Dr Dayton OH 45433-5529 |
| Practice Telephone | 9372570500 |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2018-06-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
0401413693 | VA | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 0442000128 | VA | Student, Health Care |
| Street Address |
4881 SUGAR MAPLE DR |
| City | DAYTON |
| State | OH |
| Zip Code | 45433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821611989 | Se Ha Park | Student in an Organized Health Care Education/Training Program | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2020-05-24 |
| 1841812898 | George Manoj Paul | Student in an Organized Health Care Education/Training Program | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2020-05-13 |
| 1053949198 | Jacob Aaron Freeze | Student in an Organized Health Care Education/Training Program | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2020-04-01 |
| 1326672619 | Caleb Evan Mcclary | Military Health Care Provider | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2020-02-26 |
| 1730729542 | Alan Eric Piper | Military Health Care Provider | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2020-01-09 |
| 1073161147 | Kristin Kim | Dentist | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2019-08-30 |
| 1225681117 | Kaleb Aaron Specht | Military Health Care Provider | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2019-07-19 |
| 1891347662 | Jessica Marie Gregor | Physician Assistant | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2019-07-11 |
| 1134785165 | Ethan Wilston | Student in an Organized Health Care Education/Training Program | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2019-05-15 |
| 1700381522 | Zachary Gordon Candela | Student in an Organized Health Care Education/Training Program | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2018-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891289518 | Sara Lyons | Physician Assistant | 88 Mdj/sghj, 4881 Sugar Maple Dr, Wright-patterson Afb, OH 45433 | 2018-06-16 |
| 1073001558 | Mega Margapuram | Student in an Organized Health Care Education/Training Program | 1 Sugar Maple Drive, Dayton, OH 45433 | 2018-04-30 |
| 1437667979 | Michael Peter Dring | Social Worker | Building 830, Credentials Office, 4881 Sugar Maple Rd, Wpafb, OH 45433 | 2018-01-18 |
| 1316486814 | Josiah Hardin | Internal Medicine | 88 Mdos/sgomi, 4881 Sugar Maple Dr., Wright-patterson Afb, OH 45433 | 2017-02-16 |
| 1780137380 | Allison Osterfeld | Pharmacist | 88 Mdg 4881 Suga Maple Dr, Wright Patterson Afb, OH 45433 | 2016-07-29 |
| 1891144283 | Kyle Harris | Student in an Organized Health Care Education/Training Program | 4481 Sugar Maple Dr., Wright Patterson Afb, OH 45433 | 2016-06-07 |
| 1245601756 | Nichole Griep | Audiologist | 88 Mdg/sgpq, 4881 Sugar Maple Dr, Wright-patterson Afb, OH 45433 | 2015-10-09 |
| 1487021267 | Melanie Schaffer | Dietitian, Registered | 4881 Sugamaple Drive, Wpafb, OH 45433 | 2015-08-27 |
| 1831582261 | Joseph K Wray | General Practice | 88 Mdg/sgcj, 4881 Sugar Maple Dr., Wright-patterson Afb, OH 45433 | 2015-03-10 |
| 1659798031 | Maninder Kaur | Nurse Practitioner | 88 Mdos/sgom, 4881 Sugar Maple Drive, Wright Patterson Afb, OH 45433 | 2014-03-24 |
| Find all providers in zip 45433 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225687692 | Julianne Fanny Avrutik | Dentist | 395 Ridge Rd Ste 5, Dayton, NJ 08810-1398 | 2019-09-09 |
| 1407414527 | Punyawat Laohakanjanasiri | Dentist | Dayton Va Medical Center/dental Services, 4100 W Third, Dayton, OH 45428 | 2019-06-04 |
| 1649765876 | Ryan Conner Tutor | Dentist | 225 Main St Ste 400, Dayton, TN 37321-1329 | 2018-06-29 |
| 1043765985 | Supriya Sharma | Dentist | 2411 Miamisburg Centerville Rd, Dayton, OH 45459-3723 | 2016-08-21 |
| 1871930396 | Keta Bhakta | Dentist | 13551 Balsam Ln N, Dayton, MN 55327-9464 | 2013-05-23 |
| 1932440724 | Shelhouse Dental Group LLC | Dentist | 1601 Needmore Rd, Dayton, OH 45414-3855 | 2013-03-05 |
| 1316288103 | Shelhouse Comprehensive Dental LLC | Dentist | 5335 Far Hills Ave Ste 210, Dayton, OH 45429-2317 | 2013-03-05 |
| 1346586682 | Jeffrey Craig Miller | Dentist | 4450 Linden Ave., Dayton, OH 45432 | 2012-12-13 |
| 1124307202 | Brooke D Goodwin | Dentist | 101 Heartland Ct, Dayton, VA 22821-9000 | 2011-08-08 |
| 1760795785 | Kokila Punia | Dentist | 1309 Blossom Cir, Dayton, NJ 08810-2414 | 2010-07-19 |
| Find all providers in DAYTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.