MEDICARE: DR. JOHN REDLE 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	122300000X	Dentist	30.028454	OH

General Provider Information

NPI Number	:	1821928110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN REDLE DDS

Provider Business Mailing Address
First Line	:	1322 BROOKFOREST DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-5041
Country	:	US
Telephone Number	:	330-671-1993
Fax Number	:

Provider Business Practice Location Address
First Line	:	1322 BROOKFOREST DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-5041
Country	:	US
Telephone Number	:	330-671-1993
Fax Number	:

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

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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