Healthcare Provider Details

I. General information

NPI: 1003112996
Provider Name (Legal Business Name): CASSINELLI AND SHANKER ORTHODONTICS PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2011
Last Update Date: 02/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7242 TYLERS CORNER DR
WEST CHESTER OH
45069-6334
US

IV. Provider business mailing address

7242 TYLERS CORNER DR
WEST CHESTER OH
45069-6334
US

V. Phone/Fax

Practice location:
  • Phone: 513-777-7060
  • Fax: 513-755-5632
Mailing address:
  • Phone: 513-777-7060
  • Fax: 513-755-5632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEXANDER G CASSINELLI
Title or Position: PARTNER
Credential: DMD
Phone: 513-777-7060