Healthcare Provider Details

I. General information

NPI: 1497855902
Provider Name (Legal Business Name): KEVIN DAVID HUFF DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2006
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 W 4TH ST
DOVER OH
44622-2905
US

IV. Provider business mailing address

217 W 4TH ST
DOVER OH
44622-2905
US

V. Phone/Fax

Practice location:
  • Phone: 330-364-2011
  • Fax: 330-602-3001
Mailing address:
  • Phone: 330-364-2011
  • Fax: 330-602-3001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License Number30.020488
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number20488
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: