Ollom DDS Muddy Creek LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

OLLOM DDS MUDDY CREEK LLC

Practice address

3650 Muddy Creek Rd Ste 200
Cincinnati, OH 45238-2058

Phone

(513) 922-4221

NPI assigned

Oct 20, 2021

Organization subpart

Yes

Parent organization

OLLOM ENTERPRISES LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Jane Ann Campbell

Title

Director of Operations

Phone

(567) 940-8141

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Ellen Wynn, D.D.S.

  • General Practice Dentistry
  • Cincinnati, OH
  • NPI 1710964838
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634688000000",
    "number": "1821751587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 ALLENTOWN RD STE C",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458051749",
            "telephone_number": "419-228-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 MUDDY CREEK RD STE 200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452382058",
            "telephone_number": "513-922-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLLOM DDS MUDDY CREEK LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OLLOM ENTERPRISES LLC",
        "enumeration_date": "2021-10-20",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "567-940-8141",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Oliverio, SLP CCC
• Olivia Miller Louise Olivia Miller, ED.S.
• Olivias Angels Home Carr LLC
• Petra Olivieri
• Lori Ollberding, FNP
• Adam K Olmsted, MD
• Amanda Olsen, MD
• Greg Olsen
• Leanne Olshavsky, MD
• Meagan H Olson

• Dental Clinic/Center in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Dental Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.