MEDICARE: DR. JOSEPH PAUL MAYER JR. D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	30014974	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	30014974	OTHER	OH	STATE DENTAL LICENSE
3	DT-1980	OTHER	HI	STATE DENTAL LICENSE

General Provider Information

NPI Number	:	1003902131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH PAUL MAYER JR. D.D.S.

Provider Business Mailing Address
First Line	:	2806 ERIE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-2317
Country	:	US
Telephone Number	:	513-321-3318
Fax Number	:	513-321-3008

Provider Business Practice Location Address
First Line	:	2808 ERIE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-2317
Country	:	US
Telephone Number	:	513-321-5545
Fax Number	:	513-321-3008

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/09/2007

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