Healthcare Provider Details

I. General information

NPI: 1669213476
Provider Name (Legal Business Name): CITY OF CINCINNATI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1702 GRAND AVE
CINCINNATI OH
45214-1502
US

IV. Provider business mailing address

1702 GRAND AVE
CINCINNATI OH
45214-1502
US

V. Phone/Fax

Practice location:
  • Phone: 513-357-7382
  • Fax: 513-357-7385
Mailing address:
  • Phone: 513-357-7382
  • Fax: 513-357-7385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: JOYCE TATE
Title or Position: CEO
Credential:
Phone: 513-357-7361