Provider Demographics
NPI:1184277402
Name:LOUGHRIDGE, NATHAN (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:
Last Name:LOUGHRIDGE
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 AMBERLEY CT
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-2696
Mailing Address - Country:US
Mailing Address - Phone:937-522-5138
Mailing Address - Fax:
Practice Address - Street 1:5138 CEDAR VILLAGE DR
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-3717
Practice Address - Country:US
Practice Address - Phone:513-336-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXETN699122300000X
OH30.0267671223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist