Healthcare Provider Details

I. General information

NPI: 1497668206
Provider Name (Legal Business Name): DENT DENTAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6040 HARRISON AVE
CINCINNATI OH
45248-1650
US

IV. Provider business mailing address

2905 DODGER DR APT 407
FORT DODGE IA
50501-6356
US

V. Phone/Fax

Practice location:
  • Phone: 513-574-7503
  • 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 State

VIII. Authorized Official

Name: BINGQI LUO
Title or Position: DENTIST
Credential: DDS
Phone: 510-717-7197