Provider Demographics
NPI:1982661864
Name:MASON ZIED, DENA ELISE (DO)
Entity Type:Individual
Prefix:DR
First Name:DENA
Middle Name:ELISE
Last Name:MASON ZIED
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 REMICK BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-9168
Mailing Address - Country:US
Mailing Address - Phone:937-531-0124
Mailing Address - Fax:937-531-0129
Practice Address - Street 1:10 REMICK BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-9168
Practice Address - Country:US
Practice Address - Phone:937-531-0124
Practice Address - Fax:937-531-0129
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-007978-M207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2467147Medicaid
OH4130681Medicare PIN
OHMA4130682Medicare PIN
OH4130682Medicare PIN
OH2467147Medicaid
P00144068Medicare PIN