Provider Demographics
NPI:1831725324
Name:KLUMP, SARA JANE ELISABETH (DDS)
Entity type:Individual
Prefix:
First Name:SARA JANE
Middle Name:ELISABETH
Last Name:KLUMP
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 1:231 ALBERT SABIN WAY
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45267-0769
Mailing Address - Country:US
Mailing Address - Phone:513-584-6660
Mailing Address - Fax:513-584-6661
Practice Address - Street 1:3197 LINWOOD AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-2962
Practice Address - Country:US
Practice Address - Phone:513-871-2852
Practice Address - Fax:513-871-2893
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0264181223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program