Healthcare Provider Details

I. General information

NPI: 1679457683
Provider Name (Legal Business Name): CINCINNATI DERMATOLOGY INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6552 COPPERLEAF LN
CINCINNATI OH
45230-2444
US

IV. Provider business mailing address

6552 COPPERLEAF LN
CINCINNATI OH
45230-2444
US

V. Phone/Fax

Practice location:
  • Phone: 513-400-4781
  • Fax:
Mailing address:
  • Phone: 513-400-4781
  • Fax: 662-554-4545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DENA ELKEEB
Title or Position: OWNER/REGISTERED AGENT
Credential: MD
Phone: 513-400-4781