DR. VAL RUSSELL BOUDREAU JR.


Address: 11323 Springfield Pike, Cincinnati, OH 45246-4201
Phone: 5137714080

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
20636 OH Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
OH ANTHEM MEDICAL 000000381324 01

Office Location

Street Address 11323 SPRINGFIELD PIKE
City CINCINNATI
State OH
Zip Code 45246-4201

Providers in the same location

NPI Name Taxonomy Address Enumeration
1538259536 Robert B. Ziemba Dentist 11323 Springfield Pike, Cincinnati, OH 45246-4201 2006-10-13

Providers in the same zip code

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 Information

Taxonomy Code 1223S0112X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

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

Providers in the same taxonomy and city

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

Competitor

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City CINCINNATI
Zip Code 45246

Improve Information

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Dataset Information

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.

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