Provider Demographics
NPI:1841489879
Name:FRANK RADIS, DDS, MS, INC
Entity type:Organization
Organization Name:FRANK RADIS, DDS, MS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:PARISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-562-2700
Mailing Address - Street 1:85 N CHILLICOTHE RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-8739
Mailing Address - Country:US
Mailing Address - Phone:330-562-2700
Mailing Address - Fax:330-562-0534
Practice Address - Street 1:85 N CHILLICOTHE RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-8739
Practice Address - Country:US
Practice Address - Phone:330-562-2700
Practice Address - Fax:330-562-0534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0218041223P0221X
OH191921223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2467129Medicaid
OH2050097Medicaid