Healthcare Provider Details

I. General information

NPI: 1245404581
Provider Name (Legal Business Name): SHERIDAN MILTON BILEN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2008
Last Update Date: 04/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 N SCOTT ST
NAPOLEON OH
43545-1025
US

IV. Provider business mailing address

1411 N SCOTT ST
NAPOLEON OH
43545-1025
US

V. Phone/Fax

Practice location:
  • Phone: 419-592-1781
  • Fax: 419-592-0000
Mailing address:
  • Phone: 419-592-1781
  • Fax: 419-592-0000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number20405
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number20405
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: