Healthcare Provider Details

I. General information

NPI: 1902718356
Provider Name (Legal Business Name): DRW DMD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 W DUBLIN GRANVILLE RD STE 500
COLUMBUS OH
43235-2204
US

IV. Provider business mailing address

2865 W DUBLIN GRANVILLE RD STE 500
COLUMBUS OH
43235-2204
US

V. Phone/Fax

Practice location:
  • Phone: 614-799-9500
  • Fax:
Mailing address:
  • Phone: 614-799-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: JENA TERRY
Title or Position: OFFICE MANAGER
Credential:
Phone: 614-799-9500