Healthcare Provider Details

I. General information

NPI: 1639920531
Provider Name (Legal Business Name): BELLA BUSRA AKKAYA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BUSRA NUR AKKAYA

II. Dates (important events)

Enumeration Date: 03/28/2024
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 E 6TH AVE STE 101
LANCASTER OH
43130-2595
US

IV. Provider business mailing address

121 E 6TH AVE STE 101
LANCASTER OH
43130-2595
US

V. Phone/Fax

Practice location:
  • Phone: 440-390-2335
  • Fax:
Mailing address:
  • Phone: 740-475-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.028189
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: