Organization
CLEVELAND DENTAL INSTITUTE LLC
Active
Parent organization
CLEVELAND DENTAL INSTITUTE
Organization subpart
Yes
Provider details
NPI number
Legal business name
CLEVELAND DENTAL INSTITUTE
Authorized official
DR. HUSSEIN F. ELRAWY DDS (OWNER)
(216) 727-0234
Entity
Organization
Contact information
Practice address
4071 LEE RD STE 200, CLEVELAND, OH 44128-2100
(216) 727-0234
(216) 727-1164
Mailing address
4071 LEE RD STE 200, CLEVELAND, OH 44128-2100
(216) 727-0234
(216) 727-1164
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30022649
OH
122300000X
Dentist
30023525
OH
1223E0200X
Endodontics
30024296
OH
1223P0221X
Pediatric Dentistry
30024868
OH
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
230930922
—
OH
Enumeration date
12/01/2017
Last updated
06/16/2018
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