MEDICARE: KEMAL SARVALOV

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	1223G0001X	General Practice Dentistry	30.028459	OH
2	122300000X	Dentist	30.028459	OH

General Provider Information

NPI Number	:	1457280679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEMAL SARVALOV

Provider Business Mailing Address
First Line	:	6764 RIVULET DR
Second Line	:
City	:	MIDDLETOWN
State	:	OH
Zip	:	45042-3176
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8881 GOVERNORS HILL DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45249-1337
Country	:	US
Telephone Number	:	513-912-3100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2026
Last Update Date	:	05/14/2026

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Directions to “ KEMAL SARVALOV ” Practice Location

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