Healthcare Provider Details

I. General information

NPI: 1265097901
Provider Name (Legal Business Name): CINCISMILES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2019
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5722 SIGNAL HILL CT STE A
MILFORD OH
45150-1492
US

IV. Provider business mailing address

5722 SIGNAL HILL CT STE A
MILFORD OH
45150-1492
US

V. Phone/Fax

Practice location:
  • Phone: 513-248-8848
  • Fax: 425-671-0756
Mailing address:
  • Phone: 425-503-1607
  • Fax: 425-671-0756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY KITZMILLER
Title or Position: CEO
Credential: DDS
Phone: 425-503-1607