Healthcare Provider Details

I. General information

NPI: 1659944593
Provider Name (Legal Business Name): SARA LESLIE SCHMITT OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA LESLIE WAGNER

II. Dates (important events)

Enumeration Date: 07/19/2021
Last Update Date: 12/21/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 IVY POINTE BLVD
CINCINNATI OH
45245-1767
US

IV. Provider business mailing address

3874 WYNDHAM RIDGE DR APT 312
STOW OH
44224-6171
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-6000
  • Fax:
Mailing address:
  • Phone: 513-290-7974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT.006999
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: