MEDICARE: ARLINGTON DENTAL DESIGNS, INC

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

General Provider Information

NPI Number	:	1043026891
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARLINGTON DENTAL DESIGNS, INC

Provider Business Mailing Address
First Line	:	17 NORTON RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43228-1711
Country	:	US
Telephone Number	:	614-870-3337
Fax Number	:	614-870-3339

Provider Business Practice Location Address
First Line	:	3360 TREMONT RD STE 150
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-2121
Country	:	US
Telephone Number	:	614-451-5161
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	JULIE THACKER
Credential	:
Telephone Number	:	614-870-3337

Provider Enumeration Date	:	12/06/2024
Last Update Date	:	12/06/2024

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