MEDICARE: ORTHODONTIC CONCEPTS, INC. W.D. PLIKERD, DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	30-011886	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427228972
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHODONTIC CONCEPTS, INC. W.D. PLIKERD, DDS

Provider Business Mailing Address
First Line	:	974 N 21ST ST
Second Line	:	A1
City	:	NEWARK
State	:	OH
Zip	:	43055-2990
Country	:	US
Telephone Number	:	740-366-3309
Fax Number	:	740-366-7534

Provider Business Practice Location Address
First Line	:	974 N 21ST ST
Second Line	:	A1
City	:	NEWARK
State	:	OH
Zip	:	43055-2990
Country	:	US
Telephone Number	:	740-366-3309
Fax Number	:	740-366-7534

Authorized Official
Title or Position	:	OWNER
Name	:	DR. WILLIAM D. PLIKERD
Credential	:	D.D.S.
Telephone Number	:	740-366-3309

Provider Enumeration Date	:	03/11/2008
Last Update Date	:	03/11/2008

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