Provider Demographics
NPI:1073995940
Name:KELLER, HANNAH ELIZABETH (DDS)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:ELIZABETH
Last Name:KELLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:ELIZABETH
Other - Last Name:LEFFLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5850 WECKERLY RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43571-9510
Mailing Address - Country:US
Mailing Address - Phone:419-877-5404
Mailing Address - Fax:
Practice Address - Street 1:5850 WECKERLY RD
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE
Practice Address - State:OH
Practice Address - Zip Code:43571-9510
Practice Address - Country:US
Practice Address - Phone:419-877-5404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30027182122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist