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NPI Code Detail

MEDICARE: DENTAL SERVICES OF OHIO

MEDICARE: DENTAL SERVICES OF OHIO
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
11223G0001XGeneral Practice Dentistry30-018565OH
2122300000XDentist

General Provider Information

NPI Number : 1104091651
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTAL SERVICES OF OHIO
Provider Business Mailing Address
First Line : PO BOX 11568
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66207-4268
Country : US
Telephone Number : 913-428-1674
Fax Number : 913-800-6967
Provider Business Practice Location Address
First Line : 8340 COLERAIN AVE
Second Line : STE 1
City : CINCINNATI
State : OH
Zip : 45239-3916
Country : US
Telephone Number : 513-385-5999
Fax Number : 913-800-6967
Authorized Official
Title or Position : CREDENTIALING COORDINATOR
Name : AMY WHEELER
Credential :
Telephone Number : 913-800-6952
Provider Enumeration Date : 04/25/2008
Last Update Date : 04/12/2017

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Directions to “DENTAL SERVICES OF OHIO ” Practice Location

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