Healthcare Provider Details

I. General information

NPI: 1457256638
Provider Name (Legal Business Name): SMILECRAFT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9938 WATERSTONE BLVD
CINCINNATI OH
45249-8295
US

IV. Provider business mailing address

9938 WATERSTONE BLVD
CINCINNATI OH
45249-8295
US

V. Phone/Fax

Practice location:
  • Phone: 859-935-9044
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHELDON KENNEDY
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 859-935-9044