Provider Demographics
NPI:1801889019
Name:ROGERS FAMILY DENTISTRY
Entity type:Organization
Organization Name:ROGERS FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JETTYE
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-231-1012
Mailing Address - Street 1:8284 BEECHMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3153
Mailing Address - Country:US
Mailing Address - Phone:513-231-1012
Mailing Address - Fax:513-231-3925
Practice Address - Street 1:8284 BEECHMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3153
Practice Address - Country:US
Practice Address - Phone:513-231-1012
Practice Address - Fax:513-231-3925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20093122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty