Healthcare Provider Details

I. General information

NPI: 1689296758
Provider Name (Legal Business Name): MS. BRITTINI HEMINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2020
Last Update Date: 05/12/2020
Certification Date: 05/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 BETHEL RD
COLUMBUS OH
43214-1900
US

IV. Provider business mailing address

3191 BERKLEY POINTE DR
COLUMBUS OH
43230-4880
US

V. Phone/Fax

Practice location:
  • Phone: 614-458-1711
  • Fax:
Mailing address:
  • Phone: 419-957-8999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number31.016117
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: