Healthcare Provider Details

I. General information

NPI: 1427435833
Provider Name (Legal Business Name): MARK SCHIBLER D.D.S., M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2015
Last Update Date: 07/15/2021
Certification Date: 07/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7140 MIAMI AVE STE 202
CINCINNATI OH
45243-2676
US

IV. Provider business mailing address

7140 MIAMI AVE STE 202
CINCINNATI OH
45243-2676
US

V. Phone/Fax

Practice location:
  • Phone: 513-271-5900
  • Fax:
Mailing address:
  • Phone: 513-271-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number30.026474
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: