Healthcare Provider Details

I. General information

NPI: 1316385677
Provider Name (Legal Business Name): STEVEN MICHAEL CUDNEY D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2013
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3585 WENDLETON LN
BEAVERCREEK OH
45432-2753
US

IV. Provider business mailing address

3585 WENDLETON LN
BEAVERCREEK OH
45432-2753
US

V. Phone/Fax

Practice location:
  • Phone: 937-426-8083
  • Fax: 937-426-2818
Mailing address:
  • Phone: 937-426-8083
  • Fax: 937-426-2818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number3296
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: