MEDICARE: REM DDS PLLC

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	1223D0001X	Public Health Dentistry

General Provider Information

NPI Number	:	1699623421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REM DDS PLLC

Provider Business Mailing Address
First Line	:	3475 N BEND RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239-8602
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3475 N BEND RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239-8602
Country	:	US
Telephone Number	:	402-812-2129
Fax Number	:

Authorized Official
Title or Position	:	HR ADMIN
Name	:	SHAYLA MOORE
Credential	:
Telephone Number	:	402-812-2129

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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