1154501633 NPI number — DR. MARY ELIZABETH HUNTER DDS

Table of content: DR. MARY ELIZABETH HUNTER DDS (NPI 1154501633)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154501633 NPI number — DR. MARY ELIZABETH HUNTER DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUNTER
Provider First Name:
MARY
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CLIETT
Provider Other First Name:
MARY
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1154501633
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6120 FAIRWAY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45212-1308
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-741-7779
Provider Business Mailing Address Fax Number:
513-741-8186

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8111 CHEVIOT RD
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:
45247-4013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-741-7779
Provider Business Practice Location Address Fax Number:
513-741-8186
Provider Enumeration Date:
11/13/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  30022609 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 122300000X , with the licence number: 30022609 , 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)