Alan L. Laub, D.D.S
Individual provider Active NPI Dentist · Cincinnati, OH
NPI 1063585602 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1063585602
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 17372 (OH)
- Practice address
- 1100 Bonnell St
Cincinnati, OH 45215-3248 - Phone
- (513) 563-6936
- Fax
- (513) 563-1008
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190523001963 | OH | Order and Referring Only - Dentist |
1254651813 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reading Family Dental | Past |
Accepting new patients | |
| Lauren Stevenot, DDS, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 17372 | OH | Yes |
Addresses
Primary practice location
1100 Bonnell St
Cincinnati, OH 45215-3248
Mailing address
1100 Bonnell St
Cincinnati, OH 45215-3248
Phone (513) 563-6936
Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.