Provider Demographics
NPI:1053671065
Name:TODD K. PIEPER D.D.S. FAMILY DENTISTRY
Entity Type:Organization
Organization Name:TODD K. PIEPER D.D.S. FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:KNIGHTEN
Authorized Official - Last Name:PIEPER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-229-0499
Mailing Address - Street 1:5386 COX-SMITH RD.
Mailing Address - Street 2:SUITE B
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-6803
Mailing Address - Country:US
Mailing Address - Phone:513-229-0499
Mailing Address - Fax:513-229-0496
Practice Address - Street 1:5386 COX-SMITH RD.
Practice Address - Street 2:SUITE B
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6803
Practice Address - Country:US
Practice Address - Phone:513-229-0499
Practice Address - Fax:513-229-0496
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TODD K. PIEPER D.D.S. FAMILY DENTISTRY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.018036122300000X
122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty