Provider Demographics
NPI:1265968325
Name:ELLINGER, CYNTHIA LAUREN (DDS)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:LAUREN
Last Name:ELLINGER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1648 BENNIGAN DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-8299
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7420 GOODING BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-7086
Practice Address - Country:US
Practice Address - Phone:740-548-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.025035122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist