1073903993 NPI number — KEMPER MEADOW FAMILY DENTISTRY-JOHN P HARMEYER DDS LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073903993 NPI number — KEMPER MEADOW FAMILY DENTISTRY-JOHN P HARMEYER DDS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KEMPER MEADOW FAMILY DENTISTRY-JOHN P HARMEYER DDS LLC
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:
6
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:
1073903993
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/15/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4291 SUGARCREEK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLBROOK
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45305-1330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-848-7741
Provider Business Mailing Address Fax Number:
937-848-9394

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1291 KEMPER MEADOW DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45240-1633
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-648-9900
Provider Business Practice Location Address Fax Number:
513-742-4670
Provider Enumeration Date:
01/30/2015

Additional Information

Authorized Official

Authorized Official Last Name:
HARMEYER
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
P
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
937-848-7741

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  19904 , 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)





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