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General NPI Number Information
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NPI Number | 1225055940
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Entity Type | Individual
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Provider Name | VINOD MIRIYALA DDS, BDS, MPH
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 601 N BREIEL BLVD UNIT B
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City | MIDDLETOWN
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State | OH
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Zip | 45042-3899
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Country | US
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Telephone | 513-454-1111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 837
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City | HAMILTON
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State | OH
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Zip | 45012-0837
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Country | US
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Telephone | 513-454-1111
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Fax | 740-532-4859
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 30-023190
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License Number State | OH
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