Healthcare Provider Details

I. General information

NPI: 1073431490
Provider Name (Legal Business Name): SEVA DENTAL OHIO II LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 SOM CENTER RD STE 10
WILLOUGHBY OH
44094-3044
US

IV. Provider business mailing address

5900 SOM CENTER RD STE 10
WILLOUGHBY OH
44094-3044
US

V. Phone/Fax

Practice location:
  • Phone: 440-347-9880
  • Fax:
Mailing address:
  • Phone: 440-347-9880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: KELLY ROLNICKI
Title or Position: RCM DIRECTOR
Credential:
Phone: 708-372-4773