Provider Demographics
NPI:1376737171
Name:RICHARD M. BENNINGER, DDS GARY SCHWEEN DDS AND BRIAN SCHMIDT DMD INC
Entity Type:Organization
Organization Name:RICHARD M. BENNINGER, DDS GARY SCHWEEN DDS AND BRIAN SCHMIDT DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHYR
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:ZARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-801-2698
Mailing Address - Street 1:5002 FOOTE RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-5396
Mailing Address - Country:US
Mailing Address - Phone:330-725-8449
Mailing Address - Fax:330-722-1805
Practice Address - Street 1:5002 FOOTE RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-5396
Practice Address - Country:US
Practice Address - Phone:330-725-8449
Practice Address - Fax:330-722-1805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9251381Medicare PIN