Provider Demographics
NPI:1790561835
Name:KATIE CUNNINGHAM, D.D.S., LLC
Entity Type:Organization
Organization Name:KATIE CUNNINGHAM, D.D.S., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:937-232-0532
Mailing Address - Street 1:46 SAND RUN RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-6200
Mailing Address - Country:US
Mailing Address - Phone:330-867-7746
Mailing Address - Fax:
Practice Address - Street 1:46 SAND RUN RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-6200
Practice Address - Country:US
Practice Address - Phone:330-867-7746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental