Provider Demographics
NPI:1356484430
Name:GRIFFITH, MEREDITH LEE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:LEE
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 LINCOLN BLVD
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-3138
Mailing Address - Country:US
Mailing Address - Phone:440-233-7181
Mailing Address - Fax:440-233-7847
Practice Address - Street 1:1507 LINCOLN BLVD
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-3138
Practice Address - Country:US
Practice Address - Phone:440-233-7181
Practice Address - Fax:440-233-7847
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0138231223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0182029Medicaid
OH0371391Medicare ID - Type Unspecified