MEDICARE: THOMAS NIEDERHELMAN DDS, LTD.

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	18823	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

General Provider Information

NPI Number	:	1669503033
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS NIEDERHELMAN DDS, LTD.

Provider Business Mailing Address
First Line	:	4373 E LIVINGSTON AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43227-2461
Country	:	US
Telephone Number	:	614-235-3411
Fax Number	:	614-235-2185

Provider Business Practice Location Address
First Line	:	4373 E LIVINGSTON AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43227-2461
Country	:	US
Telephone Number	:	614-235-3411
Fax Number	:	614-235-2185

Authorized Official
Title or Position	:	OWNER
Name	:	THOMAS NIEDERHELMAN
Credential	:	DDS
Telephone Number	:	614-235-3411

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	03/03/2008

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