Provider Demographics
NPI:1336629922
Name:CHRISTOPHER OMELTSCHENKO, DDS, LTD
Entity Type:Organization
Organization Name:CHRISTOPHER OMELTSCHENKO, DDS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:OMELTSCHENKO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-245-2200
Mailing Address - Street 1:6560 COLERAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-5538
Mailing Address - Country:US
Mailing Address - Phone:513-245-2200
Mailing Address - Fax:513-245-0148
Practice Address - Street 1:6560 COLERAIN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-5538
Practice Address - Country:US
Practice Address - Phone:513-245-2200
Practice Address - Fax:513-245-0148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies