Healthcare Provider Details

I. General information

NPI: 1366994584
Provider Name (Legal Business Name): DAYTON CHILDREN'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 WEST TECH ROAD
MIAMISBURG OH
45342-0817
US

IV. Provider business mailing address

1 CHILDRENS PLZ
DAYTON OH
45404-1873
US

V. Phone/Fax

Practice location:
  • Phone: 937-641-3000
  • Fax: 937-641-6116
Mailing address:
  • Phone: 937-641-3000
  • Fax: 937-641-6116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRIS BERGMAN
Title or Position: CHIEF FINANCIAL OFFICER - CFO
Credential:
Phone: 937-641-3338