# OHIO NORTH EAST HEALTH SYSTEMS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NORTHSIDE DENTAL CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730640046
- **Authorized official:** RONALD DWINNELLS MD (CEO)
- **Authorized official phone:** (330) 747-9551

## Contact information

- **Practice address:** 500 GYPSY LANE, MEDICAL OFFICE BLDG A, YOUNGSTOWN, OH 44504-1315
- **Practice address phone:** (877) 722-3303
- **Practice address fax:** (330) 884-6120
- **Mailing address:** 726 WICK AVE, YOUNGSTOWN, OH 44505-2827
- **Mailing address phone:** (330) 747-9551
- **Mailing address fax:** (330) 884-6120

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | — |
| 122300000X | Dentist | — | — | — |
| 1223G0001X | General Practice Dentistry | — | NULL | — |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |
| 124Q00000X | Dental Hygienist | — | NULL | — |
| 124Q00000X | Dental Hygienist | — | — | — |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/28/2019
- **Last updated:** 03/28/2019