MEDICARE: JANASIA DEPRIEST

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	126800000X	Dental Assistant		OH

General Provider Information

NPI Number	:	1538002779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANASIA DEPRIEST

Provider Business Mailing Address
First Line	:	3101 BURNET AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45229-3014
Country	:	US
Telephone Number	:	513-357-7382
Fax Number	:	513-357-7385

Provider Business Practice Location Address
First Line	:	3101 BURNET AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45229-3014
Country	:	US
Telephone Number	:	513-357-7382
Fax Number	:	513-357-7385

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

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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Directions to “ JANASIA DEPRIEST ” Practice Location

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