Provider Demographics
NPI:1306021324
Name:DHEENAN, SUNITA V (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNITA
Middle Name:V
Last Name:DHEENAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8556 TWILIGHT TEAR LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45249-1375
Mailing Address - Country:US
Mailing Address - Phone:513-708-0906
Mailing Address - Fax:513-469-2913
Practice Address - Street 1:1992 KING AVE
Practice Address - Street 2:
Practice Address - City:KINGS MILLS
Practice Address - State:OH
Practice Address - Zip Code:45034-8000
Practice Address - Country:US
Practice Address - Phone:513-708-0906
Practice Address - Fax:513-469-2913
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-065562207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHDH0838625Medicare PIN