Healthcare Provider Details

I. General information

NPI: 1922257906
Provider Name (Legal Business Name): RUCHIKA KHETARPAL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2008
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7074 HARRISON AVE STE 10
CINCINNATI OH
45247-8301
US

IV. Provider business mailing address

7074 HARRISON AVE STE 10
CINCINNATI OH
45247-8301
US

V. Phone/Fax

Practice location:
  • Phone: 513-923-1215
  • Fax:
Mailing address:
  • Phone: 513-923-1215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.022888
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: