Healthcare Provider Details

I. General information

NPI: 1982308409
Provider Name (Legal Business Name): RADIANCE FAMILY DENTISTRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8759 READING RD
READING OH
45215-4854
US

IV. Provider business mailing address

8759 READING RD
READING OH
45215-4854
US

V. Phone/Fax

Practice location:
  • Phone: 513-761-5050
  • Fax:
Mailing address:
  • Phone: 513-761-5050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NITENDER KUMAR
Title or Position: CEO
Credential: DDS
Phone: 513-761-5050