Provider Demographics
NPI:1043746910
Name:KD PIPER ENTERPRISES
Entity Type:Organization
Organization Name:KD PIPER ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:PIPER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-263-4040
Mailing Address - Street 1:3701 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3520
Mailing Address - Country:US
Mailing Address - Phone:614-263-4040
Mailing Address - Fax:614-267-7074
Practice Address - Street 1:1240 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-4463
Practice Address - Country:US
Practice Address - Phone:937-323-3400
Practice Address - Fax:937-323-3403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH22784122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2848913Medicaid