Ellerhorst Dental, Llc is a medicare enrolled dental clinic (Clinic/center - Dental) in Mantua, Ohio. The current practice location for Ellerhorst Dental, Llc is 10730 Main St Apt 2, Mantua, Ohio. For appointments, you can reach them via phone at
(330) 274-3495. The mailing address for Ellerhorst Dental, Llc is Po Box 350, Mantua, Ohio and phone number is (330) 221-4270.
Ellerhorst Dental, Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1740035468. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(330) 274-3495.
Dental Care Clinic Profile
| Full Name | Ellerhorst Dental, Llc |
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| Speciality | Clinic/Center |
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| Location | 10730 Main St Apt 2, Mantua, Ohio |
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| Authorized Official Name and Position | Lydia Ellerhorst (DENTIST/OWNER) |
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| Authorized Official Contact | 3302214270 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ellerhorst Dental, Llc
Po Box 350
Mantua
OH 44255-0350
Ph: (330) 221-4270 | Ellerhorst Dental, Llc
10730 Main St Apt 2
Mantua
OH 44255-8951
Ph: (330) 274-3495 |
NPI Details:
| NPI Number | 1740035468 |
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| Provider Enumeration Date | 04/17/2024 |
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| Last Update Date | 04/17/2024 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 9739623364 |
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| Medicare Enrollment ID | O20240706000246 |
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Medical Identifiers
Medical identifiers for Ellerhorst Dental, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1740035468 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Ellerhorst Dental, Llc acts as a billing entity for following providers:
| Provider Name | Lydia Bell Ellerhorst |
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| Provider Type | Practitioner - Dentist |
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| Provider Identifiers | NPI Number: 1982835492
PECOS PAC ID: 3173813151
Enrollment ID: I20240706000256 |
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