Provider Demographics
NPI:1871673152
Name:ROTTINGHAUS, DEAN G (DC)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:G
Last Name:ROTTINGHAUS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11570 LIPPELMAN RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-3916
Mailing Address - Country:US
Mailing Address - Phone:513-772-3500
Mailing Address - Fax:513-772-3511
Practice Address - Street 1:11570 LIPPELMAN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-3916
Practice Address - Country:US
Practice Address - Phone:513-772-3500
Practice Address - Fax:513-772-3511
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1862111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0945080Medicaid
KY85001659Medicaid
OHU38403Medicare UPIN
OH0730113Medicare PIN