Healthcare Provider Details

I. General information

NPI: 1366788226
Provider Name (Legal Business Name): DANIELLE KIKO MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2012
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22829 HARTLEY RD
ALLIANCE OH
44601
US

IV. Provider business mailing address

22829 HARTLEY RD
ALLIANCE OH
44601
US

V. Phone/Fax

Practice location:
  • Phone: 330-546-4175
  • Fax: 330-956-5318
Mailing address:
  • Phone: 330-546-4175
  • Fax: 330-956-5318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number35095366
License Number StateOH

VIII. Authorized Official

Name: DR. DANIELLE S KIKO
Title or Position: OWNER
Credential: MD
Phone: 330-956-5300