Provider Demographics
NPI:1396314373
Name:WOODIN, NINA (DMD)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:WOODIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 YARD ST UNIT 414
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-3592
Mailing Address - Country:US
Mailing Address - Phone:513-476-7944
Mailing Address - Fax:
Practice Address - Street 1:4089 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-1614
Practice Address - Country:US
Practice Address - Phone:513-476-7944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.026512122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist