Provider Demographics
NPI:1538295373
Name:MIDHA, SULBHA V (DDS)
Entity Type:Individual
Prefix:DR
First Name:SULBHA
Middle Name:V
Last Name:MIDHA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3532 IRWIN-SIMPSON DR
Mailing Address - Street 2:SUITE #-40
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040
Mailing Address - Country:US
Mailing Address - Phone:513-339-1932
Mailing Address - Fax:513-339-1033
Practice Address - Street 1:3532 IRWIN-SIMPSON DR
Practice Address - Street 2:SUITE #-40
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040
Practice Address - Country:US
Practice Address - Phone:513-339-1932
Practice Address - Fax:513-339-1033
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0212201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice