| Dr Deepak Gopala Krishnan, DDS | |
|
222 Piedmont Ave, Ste. 7300, Cincinnati, OH 45219-4231 | |
| (513) 475-8783 | |
| (513) 475-7698 |
| Full Name | Dr Deepak Gopala Krishnan |
|---|---|
| Gender | Male |
| Speciality | Maxillofacial Surgery |
| Experience | 30 Years |
| Location | 222 Piedmont Ave, Cincinnati, Ohio |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093974867 | NPI | - | NPPES |
| 2900874 | Medicaid | OH | |
| 7100056050 | Medicaid | KY | |
| 3000055692 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 30.024214 (Ohio) | Secondary |
| 204E00000X | Oral & Maxillofacial Surgery | 30.024214 (Ohio) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| University Of Cincinnati Medical Center, Llc | Cincinnati, OH | Hospital |
| West Chester Hospital, Llc | West chester, OH | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| University Surgical-dental Associates Llc | 1658384482 | 10 |
| Entity Name | University of Cincinnati Physicians Company LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801840434 PECOS PAC ID: 2264344480 Enrollment ID: O20031105000123 |
| Entity Name | Children's Hospital Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609915784 PECOS PAC ID: 8426955733 Enrollment ID: O20031216000035 |
| Entity Name | University Surgical-dental Associates LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649241787 PECOS PAC ID: 1658384482 Enrollment ID: O20060724000047 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Deepak Gopala Krishnan, DDS Po Box 630579, Cincinnati, OH 45263-0579 Ph: (513) 585-5501 | Dr Deepak Gopala Krishnan, DDS 222 Piedmont Ave, Ste. 7300, Cincinnati, OH 45219-4231 Ph: (513) 475-8783 |