Provider Demographics
NPI:1407019425
Name:RICHARD P CUNNINGHAM, D.D.S., LLC
Entity Type:Organization
Organization Name:RICHARD P CUNNINGHAM, D.D.S., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:R
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-885-2022
Mailing Address - Street 1:7227 N HIGH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2343
Mailing Address - Country:US
Mailing Address - Phone:614-885-2022
Mailing Address - Fax:614-888-0284
Practice Address - Street 1:7227 N HIGH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2343
Practice Address - Country:US
Practice Address - Phone:614-885-2022
Practice Address - Fax:614-888-0284
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RICHARD P CUNNINGHAM, D.D.S., LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-09
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH136521223G0001X
OH171881223P0300X
OH144241223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty