Individual
SUPRITHA NILAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
222 PIEDMONT AVE, CINCINNATI, OH 45219-4231
(513) 475-8783
(513) 475-7698
Mailing address
PO BOX 636256, CINCINNATI, OH 45263-6256
(513) 585-6200
(513) 245-3672
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DEN4589
ME
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
30.027873
OH
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
106194
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
30.027873
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0139624
—
OH
05
—
300130293
—
IN
05
—
7101055250
—
KY
Enumeration date
09/12/2017
Last updated
05/12/2026
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