Magnolia Centerville LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MAGNOLIA CENTERVILLE LLC

Doing business as

Magnolia Dental Centerville

Practice address

401 Miamisburg Centerville Rd
Centerville, OH 45459-4753

Phone

(937) 435-5073

NPI assigned

Aug 27, 2020

Last updated

Sep 4, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Meghan Koeneman

Title

Director of Revenue Cycle Managemen

Phone

(380) 203-3592

Specialties & licenses 1

Addresses

Other names 1

• Magnolia Dental Centerville Doing business as

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

{
    "created_epoch": "1598486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756944000000",
    "number": "1891308011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 MIAMISBURG CENTERVILLE RD",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MIAMISBURG CENTERVILLE RD",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594753",
            "telephone_number": "937-435-5073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8340 Yankee St",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454581808",
            "country_code": "US",
            "telephone_number": "937-435-5073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAGNOLIA CENTERVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-27",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "KOENEMAN",
        "authorized_official_first_name": "MEGHAN",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE MANAGEMEN",
        "authorized_official_telephone_number": "380-203-3592"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Dental Centerville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Centerville, OH
• Providers in Centerville, 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 Sep 4, 2025; 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.