Unknown Individual – Pediatric Dentistry, NPI 1558356030

Unknown Individual is a healthcare provider. based in Bowling green, Ohio. specializing in Pediatric Dentistry. They hold a License No. OH 12369 (OH). The NPI Number for Unknown Individual is 1558356030

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1558356030
Phone
(419) 352-3527
Address
960 W WOOSTER ST
Deactivation Date
23 October 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 960, West Wooster Street, Foxgate Farm, Westgate Homes, Bowling Green, Wood County, Ohio, 43402, United States

    STE. 201

    BOWLING GREEN, OH 434022644

    Phone: (419) 352-3527

    Fax: (419) 352-6122

    Type: Location

  • Truman Avenue, Westgate Homes, Bowling Green, Wood County, Ohio, 43402, United States

    BOWLING GREEN, OH 434022146

    Phone: (419) 352-4106

    Fax: (419) 352-6122

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 43402)

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Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1558356030 for Unknown Individual.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Pediatric Dentistry. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Bowling Green, Ohio in the same public data insurers reference.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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