Provider Demographics
NPI:1760823827
Name:THILANI M RODRIGO, DDS, INC
Entity Type:Organization
Organization Name:THILANI M RODRIGO, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THILANI
Authorized Official - Middle Name:MANJULA
Authorized Official - Last Name:RODRIGO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-891-6000
Mailing Address - Street 1:PO BOX 9671,
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209
Mailing Address - Country:US
Mailing Address - Phone:513-891-6000
Mailing Address - Fax:513-891-6001
Practice Address - Street 1:9403, KENWOOD ROAD
Practice Address - Street 2:SUITE #D102
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242
Practice Address - Country:US
Practice Address - Phone:513-891-6000
Practice Address - Fax:513-891-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-17
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300235411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty