Healthcare Provider Details

I. General information

NPI: 1821879487
Provider Name (Legal Business Name): HUTTA ORTHO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2023
Last Update Date: 10/10/2023
Certification Date: 10/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 W WILSON BRIDGE RD SUITE 265
WORTHINGTON OH
43085
US

IV. Provider business mailing address

89 W WILSON BRIDGE RD SUITE 265
WORTHINGTON OH
43085
US

V. Phone/Fax

Practice location:
  • Phone: 614-896-9090
  • Fax:
Mailing address:
  • Phone: 614-896-9090
  • Fax:

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. VICTORIA LEIGH HUTTA
Title or Position: ORTHODONTIST
Credential: DDS, MS
Phone: 614-896-9090