Provider Demographics
NPI:1528553302
Name:MICHAELS, CAROLINE MARIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:MARIE
Last Name:MICHAELS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 FISHINGER BLVD STE 262
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7570
Mailing Address - Country:US
Mailing Address - Phone:614-503-0745
Mailing Address - Fax:614-503-0747
Practice Address - Street 1:3535 FISHINGER BLVD STE 262
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7570
Practice Address - Country:US
Practice Address - Phone:614-503-0745
Practice Address - Fax:614-503-0747
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-25
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH30.0264251223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty