1982768958 NPI number — DENTAL HEALTH CENTER, INC. ONE

Table of content: (NPI 1982768958)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982768958 NPI number — DENTAL HEALTH CENTER, INC. ONE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DENTAL HEALTH CENTER, INC. ONE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982768958
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/22/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19680 CENTER RIDGE ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKY RIVER
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44116
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-251-4474
Provider Business Mailing Address Fax Number:
216-252-1988

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19680 CENTER RIDGE ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKY RIVER
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-251-4474
Provider Business Practice Location Address Fax Number:
216-252-1988
Provider Enumeration Date:
12/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
EL-HAYEK
Authorized Official First Name:
ZIAD
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
DENTIST
Authorized Official Telephone Number:
216-251-4474

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  20795 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)