| University Surgical-dental Associates, Llc | |
|
222 Piedmont Ave. Cincinnati OH 45219-4231 | |
| (513) 475-8783 | |
| (513) 475-7698 |
| Full Name | University Surgical-dental Associates, Llc |
|---|---|
| Speciality | Oral & Maxillofacial Surgery |
| Location | 222 Piedmont Ave., Cincinnati, Ohio |
| Authorized Official Name and Position | Hugh Hinds (EXECUTIVE VP/CFO) |
| Authorized Official Contact | 5135858720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| University Surgical-dental Associates, Llc 3200 Burnet Ave 3 South, Credentialing Cincinnati OH 45229-3019 Ph: (513) 585-5502 | University Surgical-dental Associates, Llc 222 Piedmont Ave. Cincinnati OH 45219-4231 Ph: (513) 475-8783 |
| NPI Number | 1649241787 |
|---|---|
| Provider Enumeration Date | 01/27/2006 |
| Last Update Date | 09/16/2019 |
| Medicare PECOS PAC ID | 1658384482 |
|---|---|
| Medicare Enrollment ID | O20060724000047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649241787 | NPI | - | NPPES |
| 0404048 | Medicaid | OH |
| Provider Name | Gary S Robins |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1205898749 PECOS PAC ID: 1456355890 Enrollment ID: I20060828000117 |
| Provider Name | Deepak Gopala Krishnan |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1093974867 PECOS PAC ID: 0941375265 Enrollment ID: I20080821000404 |
| Provider Name | Erik William Evans |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1740356534 PECOS PAC ID: 3072678010 Enrollment ID: I20090209000109 |
| Provider Name | James Alexander Phero |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1881034304 PECOS PAC ID: 5193941672 Enrollment ID: I20190717000300 |
| Provider Name | Wallace S Mclaurin |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1467846824 PECOS PAC ID: 4981916095 Enrollment ID: I20191213002371 |
| Provider Name | Hether Khosa |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1972857506 PECOS PAC ID: 3678871043 Enrollment ID: I20200206000576 |
| Provider Name | Michael James Grau |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1801058334 PECOS PAC ID: 2567893274 Enrollment ID: I20200513002289 |
| Provider Name | Alexa Gadomski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306431648 PECOS PAC ID: 6507272655 Enrollment ID: I20210315002761 |
| Provider Name | Petra Olivieri |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1013460658 PECOS PAC ID: 7012318629 Enrollment ID: I20210701003801 |
| Provider Name | Mi Young Kim |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1770965667 PECOS PAC ID: 3870899628 Enrollment ID: I20210901001759 |
| Provider Name | Andres David Flores Hidalgo |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1720455686 PECOS PAC ID: 4183952724 Enrollment ID: I20230822003801 |
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Richard L. Jackson, D.d.s., Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3650 Erie Ave, Cincinnati, OH 45208 Phone: 513-321-3037 Fax: 513-321-2071 | |
Cincysmiles Foundation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 635 W 7th St, Suite 405, Cincinnati, OH 45203 Phone: 513-621-0248 Fax: 513-621-0288 | |
City Of Cincinnati Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 612 Rockdale Ave, Cincinnati, OH 45229 Phone: 513-352-4072 Fax: 513-352-4075 | |
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