BEAVERCREEK DERMATOLOGY LLC (NPI# 1265535140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265535140 |
| Entity Type | Organization |
| Organization Name | BEAVERCREEK DERMATOLOGY LLC |
| Practice Address |
3572 Dayton-xenia Rd Suite 105 Beavercreek OH 45432-2838 |
| Practice Telephone | 9374274600 |
| Practice Fax Number | 9374274520 |
| Mailing Telephone | 9374274600 |
| Mailing Fax Number | 9374274520 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. KATHRYN V BALAZS (PRACTICE OWNER PHYSICIAN) |
| Authorized Official Telephone | 9374274600 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| X | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3572 DAYTON-XENIA RD SUITE 105 |
| City | BEAVERCREEK |
| State | OH |
| Zip Code | 45432-2838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538789284 | Shannon Davis Kaufman | Counselor | National Youth Advocate Program, 1020 Woodman Drive Suite 330, Dayton, OH 45432 | 2020-04-23 |
| 1215480504 | Heather Iaquinta | Registered Nurse | 1430 Linden Ave., Suite 390, Dayton, OH 45432 | 2016-08-03 |
| 1346586682 | Jeffrey Craig Miller | Dentist | 4450 Linden Ave., Dayton, OH 45432 | 2012-12-13 |
| 1194997718 | Paul G Tarlano Dds Inc | Dentist | 3621 Dayton-xenia Rd, Beaver Creek, OH 45432 | 2008-03-25 |
| 1306018981 | Paul Gerald Tarlano | Dentist | 3621 Dayton Xenia Rd, Beavercreek, OH 45432 | 2008-03-24 |
| 1104035377 | Andrew Brody | Occupational Therapy Assistant | 1974 North Fairfield Road, Beavercreek, OH 45432 | 2007-05-22 |
| 1952476111 | Jeffrey C Miller Dds Inc | Dentist | 4450 Linden Ave, Dayton, OH 45432 | 2006-11-22 |
| 1194898098 | Joseph Warren Shiveley | Dentist | 1555 Marsetta Drive, Dayton, OH 45432 | 2006-11-16 |
| 1710907597 | Integrated Youth Services Inc | Clinic/Center | 1321 Research Park Drive, Dayton, OH 45432 | 2006-07-21 |
| 1730106790 | Lorena L Kvalheim | Psychologist | 1020 Woodman Street, Suite 300, Dayton, OH 45432 | 2006-07-16 |
| Find all providers in zip 45432 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669472650 | Kathryn Vancko Balazs | Dermatology | 3572 Dayton Xenia Rd, Suite 105, Beavercreek, OH 45432-2886 | 2005-07-30 |
| 1568955300 | Elizabeth Joan Usedom | Dermatology | 725 University Blvd, Beavercreek, OH 45324-2640 | 2018-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023623808 | Bria Deshea Barjuca | Dermatology | 4450 Eastgate Blvd Ste 232, Cincinnati, OH 45245-1788 | 2020-09-09 |
| 1184263675 | Sunkiss Essentials LLC | Dermatology | 2926 State Rd Ste 369, Cuyahoga Falls, OH 44223-1244 | 2019-12-31 |
| 1770048894 | Teresa O'connell | Dermatology | Timeless Skin Solutions, 31 South High St, Dublin, OH 43017 | 2019-02-02 |
| 1144737560 | Robert Brody Md Co | Dermatology | 3461 Warrensville Center Rd Ste 101, Shaker Heights, OH 44122-5227 | 2018-01-08 |
| 1366893752 | Kirsten Dickinson | Dermatology | Cleveland Clinic 9500 Euclin Ave, Cleveland, OH 44195-1009 | 2016-06-27 |
| 1649629692 | Megan Ashley Jones-sheets | Dermatology | 75 Metro Place North, Suite 195, Dublin, OH 43017 | 2016-06-10 |
| 1275982746 | Samantha N Barry | Dermatology | 9403 Kenwood Rd Ste B100, Blue Ash, OH 45242-6858 | 2016-06-06 |
| 1720433592 | Nitin Tiwari | Dermatology | 4439 State Route 159 Ste G50, Chillicothe, OH 45601-7202 | 2016-04-29 |
| 1487008751 | Kiyanna Marie Williams | Dermatology | 2049 E 100th St A Building, Cleveland, OH 44195-1014 | 2016-04-22 |
| 1336502038 | Jacqueline Graham | Dermatology | 566 White Pond Dr Ste E, Akron, OH 44320-1116 | 2016-03-30 |
| Find all providers with the same taxonomy | ||||
| City | BEAVERCREEK |
| Zip Code | 45432 |
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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.