MEDICARE: TYLER PARRISH DMD WHITE OAK LLC

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	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1053279182
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TYLER PARRISH DMD WHITE OAK LLC

Provider Business Mailing Address
First Line	:	8111 CHEVIOT RD STE 102
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45247-4013
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8111 CHEVIOT RD STE 102
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45247-4013
Country	:	US
Telephone Number	:	513-715-2026
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	JESSE IVIE
Credential	:
Telephone Number	:	208-539-9876

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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