Healthcare Provider Details

I. General information

NPI: 1205583614
Provider Name (Legal Business Name): CHARLOTTE ANN SJULIN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LOTTE SJULIN DDS

II. Dates (important events)

Enumeration Date: 03/05/2022
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 FISHINGER BLVD
HILLIARD OH
43026-7504
US

IV. Provider business mailing address

3535 FISHINGER BLVD
HILLIARD OH
43026-7504
US

V. Phone/Fax

Practice location:
  • Phone: 614-876-4277
  • Fax:
Mailing address:
  • Phone: 614-876-4277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number30.027967
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number30.027967
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDEN.00205940
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: