Provider Demographics
NPI:1215808589
Name:MIDDLETOWN DENTAL EXCELLENCE LLC
Entity type:Organization
Organization Name:MIDDLETOWN DENTAL EXCELLENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:HAIDER
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:SR
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-515-5256
Mailing Address - Street 1:4983 OLD IRWIN SIMPSON RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-9751
Mailing Address - Country:US
Mailing Address - Phone:513-515-5256
Mailing Address - Fax:
Practice Address - Street 1:4983 OLD IRWIN SIMPSON RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-9751
Practice Address - Country:US
Practice Address - Phone:513-515-5256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty