=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477761831
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RINALDI ORTHODONTICS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/18/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5987 MEIJER DRIVE
-----------------------------------------------------
City | MILFORD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45150
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-831-6160
-----------------------------------------------------
Fax | 513-831-6338
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5987 MEIJER DRIVE
-----------------------------------------------------
City | MILFORD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45150
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-831-6160
-----------------------------------------------------
Fax | 513-831-6338
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ORTHODONTIST
-----------------------------------------------------
Name | DR. ANTHONY LAWRENCE RINALDI
-----------------------------------------------------
Credential | DDS MS
-----------------------------------------------------
Telephone | 513-831-6160
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223X0400X
-----------------------------------------------------
Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
-----------------------------------------------------
License Number | 30020922
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------