MEDICARE: ADVANCED BREAST & COSMETIC SURGERY INC

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	208200000X	Plastic Surgery Physician
2	208200000X	Plastic Surgery Physician	35054567R	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000186344	OTHER	OH	ANTHEM
2	2589812	OTHER	OH	UHC

General Provider Information

NPI Number	:	1811098452
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED BREAST & COSMETIC SURGERY INC

Provider Business Mailing Address
First Line	:	2361 LAKEVIEW DR
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45431-3695
Country	:	US
Telephone Number	:	937-704-2130
Fax Number	:	937-704-2140

Provider Business Practice Location Address
First Line	:	580 LINCOLN PARK BLVD STE 255
Second Line	:
City	:	KETTERING
State	:	OH
Zip	:	45429-3493
Country	:	US
Telephone Number	:	937-949-8457
Fax Number	:	937-949-8695

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SUNISHKA M WIMALAWANSA
Credential	:	MD
Telephone Number	:	937-704-2130

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	06/18/2025

Similar Medicare Providers

1801840046 — HEARTLAND HOSPICE SERVICES LLC
Practice Location Address:

580 LINCOLN PARK BLVD , SUITE 320
KETTERING, OH
45429-3493

Practice Phone: 937-299-6980
Practice Fax: 937-293-6399

1194770453 — DAVID B SHUSTER MD
Practice Location Address:

580 LINCOLN PARK BLVD STE 255
KETTERING, OH
45429-3493

Practice Phone: 937-266-4668
Practice Fax: 866-839-8449

1902950249 — MRS. AMY LORETTA JONES RN
Practice Location Address:

580 LINCOLN PARK BLVD STE 320
KETTERING, OH
45429-3493

Practice Phone: 937-299-6980
Practice Fax:

1568640068 — CAMBRIDGE HOME HEALTH CARE, INC
Practice Location Address:

580 LINCOLN PARK BLVD STE 101
KETTERING, OH
45429-3493

Practice Phone: 937-643-2422
Practice Fax: 937-643-2415

1023311222 — ASSISTED CARE BY BLACK STONE OF DAYTON, LLC
Practice Location Address:

580 LINCOLN PARK BLVD STE 101
KETTERING, OH
45429-3493

Practice Phone: 937-643-2422
Practice Fax: 937-643-2415

1982139176 — SPENCER ROBERT ANDERSON M.D.
Practice Location Address:

580 LINCOLN PARK BLVD STE 225
KETTERING, OH
45429-3493

Practice Phone: 937-949-8457
Practice Fax: 937-949-8695

Directions to “ADVANCED BREAST & COSMETIC SURGERY INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.