Healthcare Provider Details

I. General information

NPI: 1821965070
Provider Name (Legal Business Name): DANIELLE RULLI RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2025
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 W 12TH AVE
COLUMBUS OH
43210-1267
US

IV. Provider business mailing address

1111 MIAMI DR
MARYSVILLE OH
43040-8170
US

V. Phone/Fax

Practice location:
  • Phone: 614-292-7639
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number31017489
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: