Healthcare Provider Details

I. General information

NPI: 1699607622
Provider Name (Legal Business Name): TARA CAMPISANO DDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3026 MADISON RD
CINCINNATI OH
45209-1710
US

IV. Provider business mailing address

3026 MADISON RD
CINCINNATI OH
45209-1710
US

V. Phone/Fax

Practice location:
  • Phone: 513-909-2337
  • Fax:
Mailing address:
  • Phone: 513-909-2337
  • 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: TARA CAMPISANO
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 513-205-4879