DR. VAL RUSSELL BOUDREAU JR. (NPI# 1033209028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033209028 |
Entity Type | Individual |
Full Name | DR. VAL RUSSELL BOUDREAU JR. |
Credential | D.D.S. |
Practice Address |
11323 Springfield Pike Cincinnati OH 45246-4201 |
Practice Telephone | 5137714080 |
Practice Fax Number | 5133262022 |
Mailing Telephone | 5137714080 |
Mailing Fax Number | 5133262022 |
Enumeration Date | 2006-10-13 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
20636 | OH | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OH | ANTHEM MEDICAL | 000000381324 | 01 |
Street Address |
11323 SPRINGFIELD PIKE |
City | CINCINNATI |
State | OH |
Zip Code | 45246-4201 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538259536 | Robert B. Ziemba | Dentist | 11323 Springfield Pike, Cincinnati, OH 45246-4201 | 2006-10-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033766241 | Stephanie Ann Hayes | Counselor | 42 East Crescentville Drive, Cincinnati, OH 45246 | 2019-08-22 |
1689228132 | Jessica D Mandich | Social Worker | 415 Glensprings Drive Suite 201, Cincinnati, OH 45246 | 2019-08-01 |
1649832338 | Combine Home Care | Home Health | 260 Northland Blvd Ste 234, Cincinnati, OH 45246 | 2019-07-02 |
1215593488 | Premier Care of Ohio, LLC. | Clinic/Center | 42 E Crescentville Road, Cincinnati, OH 45246 | 2019-05-14 |
1295205276 | Emmanuel Bio Antwi | Adult Companion | 230 Northland Blvd Suite 112, Cincinnati, OH 45246 | 2018-12-03 |
1225567506 | Rebecca J Travis | Case Manager/Care Coordinator | 11590 Century Blvd Suite 116, Cincinnati, OH 45246 | 2017-06-08 |
1245770320 | Tiffany Burton | Behavior Technician | 11789 Rose Lane, Cincinnati, OH 45246 | 2017-03-08 |
1306207964 | Adriana Harris | Home Health Aide | 270 Northland Blvd Ste 112, Springdale, OH 45246 | 2016-03-10 |
1891124251 | Leslie Ann Cooper | Social Worker | 316 Cleveland Avenue, Cincinnati, OH 45246 | 2013-11-06 |
1144564071 | Premier Care of Ohio, Inc. | Community/Behavioral Health | 42 E. Crescentville Road, West Chester, OH 45246 | 2012-11-15 |
Find all providers in zip 45246 |
Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710204920 | Gary Howard Wilcox Jr. | Dentist | 7140 Miami Ave Ste 202, Cincinnati, OH 45243-2676 | 2010-04-27 |
1861685968 | Cincinnati Oral & Maxillofacial Surgery Assoc., Inc. | Dentist | 7803 5 Mile Rd, Cincinnati, OH 45230-2347 | 2007-08-22 |
1982897088 | Cincinnatioral&maxillofacial Surgery Assoc.,inc. | Dentist | 7611 Cheviot Rd, Cincinnati, OH 45247-4036 | 2007-08-22 |
1285851857 | Lester Marc Lubitz | Dentist | 11438 Lebanon Pike, Suite F, Cincinnati, OH 45241 | 2007-04-18 |
1497898241 | Gary George Pies | Dentist | 3020 Banning Road, Cincinnati, OH 45239-5203 | 2007-02-14 |
1447344916 | Steven P Pieper | Dentist | 7140 Miami Ave, Suite 202, Cincinnati, OH 45243 | 2006-10-02 |
1720185135 | James David White | Dentist | 9509 Montgomery Rd, Cincinnati, OH 45242-7235 | 2006-09-20 |
1598779548 | Steven Jay Reubel | Dentist | 7729 Montgomery Rd, Cincinnati, OH 45236-4201 | 2006-07-27 |
1932739190 | Oral & Maxillofacial Surgery of Ohio | Dentist | 7462 Jager Ct, Cincinnati, OH 45230-4344 | 2020-01-16 |
1548829245 | Cincinnati Center for Corrective Jaw Surgery | Dentist | 7523 State Rd, Cincinnati, OH 45255-2438 | 2019-06-07 |
Find all providers in CINCINNATI |
City | CINCINNATI |
Zip Code | 45246 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.