Healthcare Provider Details

I. General information

NPI: 1881788404
Provider Name (Legal Business Name): LUCIA C GERSTMANN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 05/09/2022
Certification Date: 05/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 BUTTERFLY GARDENS DR
COLUMBUS OH
43215-7508
US

IV. Provider business mailing address

700 CHILDRENS DR
COLUMBUS OH
43205-2639
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-5650
  • Fax:
Mailing address:
  • Phone: 614-722-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number30021521
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: