Provider Demographics
NPI:1831985571
Name:DIDIS HAIR COLLECTION LLC
Entity type:Organization
Organization Name:DIDIS HAIR COLLECTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DISSIRAMA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BETIMBENA
Authorized Official - Suffix:
Authorized Official - Credentials:SOLE MBR
Authorized Official - Phone:513-747-0460
Mailing Address - Street 1:11260 CHESTER RD FL 7
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-4048
Mailing Address - Country:US
Mailing Address - Phone:513-747-0460
Mailing Address - Fax:
Practice Address - Street 1:11260 CHESTER RD FL 7
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-4048
Practice Address - Country:US
Practice Address - Phone:513-747-0460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier