Provider Demographics
NPI:1871657007
Name:SHERIDAN M BILEN DDS LTD
Entity Type:Organization
Organization Name:SHERIDAN M BILEN DDS LTD
Other - Org Name:BILEN FAMILY DENISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHERIDAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BILEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-592-1781
Mailing Address - Street 1:1411 N SCOTT ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:NAPOLEON
Mailing Address - State:OH
Mailing Address - Zip Code:43545
Mailing Address - Country:US
Mailing Address - Phone:419-592-1781
Mailing Address - Fax:419-592-0000
Practice Address - Street 1:1411 N SCOTT ST
Practice Address - Street 2:SUITE A
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545
Practice Address - Country:US
Practice Address - Phone:419-592-1781
Practice Address - Fax:419-592-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH204051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty