Healthcare Provider Details

I. General information

NPI: 1104739242
Provider Name (Legal Business Name): RUSTY M. ALBRECHT, D.D.S., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9659 OLD JOHNNYCAKE RIDGE RD
CONCORD TWP OH
44060-6520
US

IV. Provider business mailing address

9659 OLD JOHNNYCAKE RIDGE RD
CONCORD TWP OH
44060-6520
US

V. Phone/Fax

Practice location:
  • Phone: 440-358-0495
  • Fax: 440-358-0496
Mailing address:
  • Phone: 440-358-0495
  • Fax: 440-358-0496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. RUSTY M. ALBRECHT
Title or Position: OWNER
Credential: D.D.S.
Phone: 440-358-0495