Healthcare Provider Details

I. General information

NPI: 1649493826
Provider Name (Legal Business Name): STEVEN C. EMRICH, DDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 POLARIS WOODS BLVD
WESTERVILLE OH
43082-8076
US

IV. Provider business mailing address

937 POLARIS WOODS BLVD
WESTERVILLE OH
43082-8076
US

V. Phone/Fax

Practice location:
  • Phone: 614-888-4577
  • Fax: 614-888-9740
Mailing address:
  • Phone: 614-888-4577
  • Fax: 614-888-9740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number30 016414
License Number StateOH

VIII. Authorized Official

Name: DR. STEVEN CHRISTOPHER EMRICH
Title or Position: OWNER
Credential: DDS, MS
Phone: 614-888-4577