Provider Demographics
NPI:1871669754
Name:WEINSTEIN, DANIEL L (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:L
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 BAUM STREET
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1870
Mailing Address - Country:US
Mailing Address - Phone:513-830-7184
Mailing Address - Fax:
Practice Address - Street 1:10545 MONTGOMERY ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-4447
Practice Address - Country:US
Practice Address - Phone:513-793-0880
Practice Address - Fax:513-793-0881
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30014342122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9179788OtherDORAL
OH0280011Medicaid
OH743046785027OtherCARESOURCE