Provider Demographics
NPI:1679203012
Name:RADIN DENTAL LLC
Entity Type:Organization
Organization Name:RADIN DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:J
Authorized Official - Last Name:RADIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:216-394-9657
Mailing Address - Street 1:13303 PRESCOTT LANE
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136
Mailing Address - Country:US
Mailing Address - Phone:216-394-9657
Mailing Address - Fax:
Practice Address - Street 1:6200 SAM CENTER RD
Practice Address - Street 2:SUITE B10
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139
Practice Address - Country:US
Practice Address - Phone:440-542-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty