Healthcare Provider Details

I. General information

NPI: 1932739190
Provider Name (Legal Business Name): ORAL & MAXILLOFACIAL SURGERY OF OHIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2020
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7462 JAGER CT
CINCINNATI OH
45230-4344
US

IV. Provider business mailing address

7462 JAGER CT
CINCINNATI OH
45230-4344
US

V. Phone/Fax

Practice location:
  • Phone: 513-232-4600
  • Fax: 513-232-8764
Mailing address:
  • Phone: 513-232-4600
  • Fax: 513-232-8764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. BABAK EMAMI
Title or Position: OWNER/SURGEON
Credential: DMD
Phone: 513-232-4600