Healthcare Provider Details

I. General information

NPI: 1750408985
Provider Name (Legal Business Name): DAVID G AUSTIN DDS INC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 OLENTANGY RIVER RD SUITE B 1
COLUMBUS OH
43214-3437
US

IV. Provider business mailing address

3600 OLENTANGY RIVER RD SUITE B 1
COLUMBUS OH
43214-3437
US

V. Phone/Fax

Practice location:
  • Phone: 614-451-3600
  • Fax: 614-451-3726
Mailing address:
  • Phone: 614-451-3600
  • Fax: 614-451-3726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number30016555
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number30016555
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License Number30016555
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: