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General NPI Number Information
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NPI Number | 1619814795
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Entity Type | Individual
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Provider Name | PAULA ILLEIN
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Gender | Female
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Dates
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Enumeration Date | 04/29/2026
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Last Update Date | 04/29/2026
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Provider Practice Location Address
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Address Line | 3101 BURNET AVE
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City | CINCINNATI
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State | OH
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Zip | 45229-3014
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Country | US
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Telephone | 513-357-7495
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Fax |
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Provider Business Mailing Address
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Address Line | 3718 MEAD AVE
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City | CINCINNATI
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State | OH
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Zip | 45226-1520
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Country | US
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Telephone | 513-357-7387
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Fax |
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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 | 126800000X
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Taxonomy Name | Dental Assistant
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License Number | 004052
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License Number State | OH
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