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NPI Code Detail

MEDICARE: DR. HETHER KHOSA DDS

MEDICARE: DR. HETHER KHOSA 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
11223S0112XOral and Maxillofacial Surgery (Dentist)30.025966OH
2204E00000XOral & Maxillofacial Surgery (D.M.D.)30.025966OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972857506
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HETHER KHOSA DDS
Provider Business Mailing Address
First Line : 222 PIEDMONT AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45219-4231
Country : US
Telephone Number : 513-475-8783
Fax Number :
Provider Business Practice Location Address
First Line : 222 PIEDMONT AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45219-4231
Country : US
Telephone Number : 513-475-8783
Fax Number : 513-475-7698
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2012
Last Update Date : 05/11/2026

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Directions to “ DR. HETHER KHOSA DDS” Practice Location

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