Provider Demographics
NPI:1700438041
Name:JOSHUA D. ATKIN D.D.S., LLC
Entity Type:Organization
Organization Name:JOSHUA D. ATKIN D.D.S., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:ATKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-446-6737
Mailing Address - Street 1:3609 N DIXIE DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-5232
Mailing Address - Country:US
Mailing Address - Phone:937-278-7954
Mailing Address - Fax:
Practice Address - Street 1:3609 N DIXIE DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-5232
Practice Address - Country:US
Practice Address - Phone:937-278-7954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0692415Medicaid
OH2741644Medicaid
OH2653552Medicaid