| Ohio State Dental Faculty Practice Inc- John R Kalmar, Dmd, Phd | |
|
305 W. 12th Avenue 4th Floor Postle Hall Columbus OH 43210-1267 | |
| (614) 292-1472 | |
| (614) 688-3553 |
| Full Name | Ohio State Dental Faculty Practice Inc- John R Kalmar, Dmd, Phd |
|---|---|
| Speciality | Dentist |
| Location | 305 W. 12th Avenue, Columbus, Ohio |
| Authorized Official Name and Position | Linda Murray Myers (DIRECTOR) |
| Authorized Official Contact | 6146884378 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ohio State Dental Faculty Practice Inc- John R Kalmar, Dmd, Phd 305 W 12th Ave 2301 Postle Hall Columbus OH 43210-1267 Ph: (614) 292-1472 | Ohio State Dental Faculty Practice Inc- John R Kalmar, Dmd, Phd 305 W. 12th Avenue 4th Floor Postle Hall Columbus OH 43210-1267 Ph: (614) 292-1472 |
| NPI Number | 1164537684 |
|---|---|
| Provider Enumeration Date | 08/21/2006 |
| Last Update Date | 11/09/2021 |
| Medicare PECOS PAC ID | 5496788630 |
|---|---|
| Medicare Enrollment ID | O20050916000944 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164537684 | NPI | - | NPPES |
| 0799104 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| Provider Name | Kelly Sue Kennedy |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1568673366 PECOS PAC ID: 7911062955 Enrollment ID: I20090209000081 |
| Provider Name | Reza Heshmati |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1508929753 PECOS PAC ID: 4688731573 Enrollment ID: I20090319000671 |
| Provider Name | Kristin Kay Mcnamara |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1366659658 PECOS PAC ID: 7315088325 Enrollment ID: I20100112000521 |
| Provider Name | Gregory Ness |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1528037413 PECOS PAC ID: 3870521123 Enrollment ID: I20111121000520 |
| Provider Name | John Kalmar |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1952464109 PECOS PAC ID: 3375701402 Enrollment ID: I20120221000810 |
| Provider Name | Peter Larsen |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1205912300 PECOS PAC ID: 2567640832 Enrollment ID: I20120227000843 |
| Provider Name | Susan Mallery |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1083688865 PECOS PAC ID: 3274782370 Enrollment ID: I20121004000860 |
| Provider Name | Courtney A Jatana |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1912125899 PECOS PAC ID: 4486805603 Enrollment ID: I20121117000069 |
| Provider Name | Christine Harrington |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1649239625 PECOS PAC ID: 3971765686 Enrollment ID: I20130424000770 |
| Provider Name | Hany Emam |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1316176944 PECOS PAC ID: 0547403628 Enrollment ID: I20130821001037 |
| Provider Name | Robert A Busto |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1811102338 PECOS PAC ID: 6709155542 Enrollment ID: I20200804003128 |
| Provider Name | James H Cottle |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1730251869 PECOS PAC ID: 7012366206 Enrollment ID: I20231213002289 |
| Provider Name | Hong Chen |
|---|---|
| Provider Type | Practitioner - Orofacial Pain |
| Provider Identifiers | NPI Number: 1760593669 PECOS PAC ID: 0345255527 Enrollment ID: I20240131004702 |
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