# UNIVERSITY SURGICAL-DENTAL ASSOCIATES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** University Surgical Dental Associates, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649241787
- **Authorized official:** HUGH HINDS (EXECUTIVE VP/CFO)
- **Authorized official phone:** (513) 585-8720

## Contact information

- **Practice address:** 222 PIEDMONT AVE., CINCINNATI, OH 45219-4231
- **Practice address phone:** (513) 475-8783
- **Practice address fax:** (513) 475-7698
- **Mailing address:** 3200 BURNET AVE, 3 SOUTH, CREDENTIALING, CINCINNATI, OH 45229-3019
- **Mailing address phone:** (513) 585-5502
- **Mailing address fax:** (513) 585-5511

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | Yes |

## Other

- **Enumeration date:** 01/27/2006
- **Last updated:** 09/16/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0404048 | — | OH |