Healthcare Provider Details

I. General information

NPI: 1730527102
Provider Name (Legal Business Name): PETER J. AHN, D.D.S., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2013
Last Update Date: 06/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5274 CLEVELAND AVE
COLUMBUS OH
43231-4781
US

IV. Provider business mailing address

5274 CLEVELAND AVE
COLUMBUS OH
43231-4781
US

V. Phone/Fax

Practice location:
  • Phone: 614-426-4554
  • Fax: 614-426-4556
Mailing address:
  • Phone: 614-426-4554
  • Fax: 614-426-4556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. PETER JUNSUN AHN
Title or Position: DENTIST
Credential: D.D.S.
Phone: 614-426-4554