Healthcare Provider Details

I. General information

NPI: 1609535251
Provider Name (Legal Business Name): BEAUTY MARK AESTHETICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2021
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 HEWITT AVE
DAYTON OH
45440-2917
US

IV. Provider business mailing address

4300 TOLL GATE LN
BELLBROOK OH
45305-1235
US

V. Phone/Fax

Practice location:
  • Phone: 937-867-7700
  • Fax:
Mailing address:
  • Phone: 937-867-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHELBY SCHRAMM
Title or Position: PROVIDER
Credential:
Phone: 937-867-7700