Provider Demographics
NPI:1013986595
Name:DR. FIXLER'S DENTAL SERVICES, LLC
Entity Type:Organization
Organization Name:DR. FIXLER'S DENTAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FIXLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:216-214-4933
Mailing Address - Street 1:14100 CEDAR RD
Mailing Address - Street 2:STE 200
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3212
Mailing Address - Country:US
Mailing Address - Phone:216-214-4933
Mailing Address - Fax:216-383-3625
Practice Address - Street 1:14100 CEDAR RD
Practice Address - Street 2:STE 200
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44121-3212
Practice Address - Country:US
Practice Address - Phone:216-214-4933
Practice Address - Fax:216-383-3625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2283032Medicaid