Provider Demographics
NPI:1912345760
Name:POWERS, NATHAN JAMES (DMD)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:JAMES
Last Name:POWERS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6839 WOOSTER PIKE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-4328
Mailing Address - Country:US
Mailing Address - Phone:513-271-6322
Mailing Address - Fax:513-271-6373
Practice Address - Street 1:6839 WOOSTER PIKE
Practice Address - Street 2:
Practice Address - City:MARIEMONT
Practice Address - State:OH
Practice Address - Zip Code:45227
Practice Address - Country:US
Practice Address - Phone:513-271-6322
Practice Address - Fax:513-271-6373
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-024474122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist