Provider Demographics
NPI:1770149445
Name:POLLINA, OLIVIA MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:MARIE
Last Name:POLLINA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:OLIVIA
Other - Middle Name:MARIE
Other - Last Name:JOHNTONY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6415 AEROS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-5071
Mailing Address - Country:US
Mailing Address - Phone:330-881-2322
Mailing Address - Fax:
Practice Address - Street 1:4168 BUCKEYE PKWY
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-8175
Practice Address - Country:US
Practice Address - Phone:614-801-5620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-17
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.025738122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH30.025738OtherDENTAL LICENSE