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General NPI Number Information
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NPI Number | 1841200029
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Entity Type | Organization
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Legal Business Name | FIXARI FAMILY DENTAL LLC
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 12/28/2023
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Provider Practice Location Address
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Address Line | 10700 BLACKLICK EASTERN ROAD
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City | PICKERINGTON
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State | OH
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Zip | 43147
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Country | US
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Telephone | 614-866-7445
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Fax | 614-866-8750
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Provider Business Mailing Address
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Address Line | 6441 WINCHESTER BLVD
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City | CANAL WINCHESTER
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State | OH
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Zip | 43110
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Country | US
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Telephone | 614-866-7445
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Fax | 614-866-8750
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHAYNE FIXARI
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Credential |
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Telephone | 614-580-3290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 18642
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License Number State | OH
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