Healthcare Provider Details

I. General information

NPI: 1477002640
Provider Name (Legal Business Name): CAROLYN D BEDNAR DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2016
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

686 CORYLUS DR
PATASKALA OH
43062-7628
US

IV. Provider business mailing address

12444 TEAL LN
PICKERINGTON OH
43147-8496
US

V. Phone/Fax

Practice location:
  • Phone: 614-980-8747
  • Fax: 614-452-8098
Mailing address:
  • Phone: 614-980-8747
  • Fax: 614-452-8098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CAROLYN BEDNAR
Title or Position: OWNER
Credential: DDS
Phone: 614-980-8747