MEDICARE: DR. WENDI O'NEILL DDS

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	1223P0106X	Oral and Maxillofacial Pathology Dentistry	30.027362	OH

General Provider Information

NPI Number	:	1134484959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WENDI O'NEILL DDS

Provider Business Mailing Address
First Line	:	2103 CORNELL RD RM 2134
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-3860
Country	:	US
Telephone Number	:	614-270-2060
Fax Number	:

Provider Business Practice Location Address
First Line	:	2103 CORNELL RD RM 2134
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-3860
Country	:	US
Telephone Number	:	614-270-2060
Fax Number	:

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

Provider Enumeration Date	:	07/09/2012
Last Update Date	:	07/03/2024

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