Provider Demographics
NPI:1386801231
Name:KESSLING, TIFFANY L (DDS)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:L
Last Name:KESSLING
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:GRANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:700 ACKERMAN RD
Mailing Address - Street 2:SUITE 570
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-8074
Mailing Address - Fax:614-293-3193
Practice Address - Street 1:460 W 10TH AVE
Practice Address - Street 2:5TH FLOOR
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210
Practice Address - Country:US
Practice Address - Phone:614-293-8074
Practice Address - Fax:614-293-3193
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0227741223G0001X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP01545045OtherRAILROAD MEDICARE
OH0109327Medicaid
OHP01545045OtherRAILROAD MEDICARE