Provider Demographics
NPI:1396459145
Name:SAVANNAH BUDDE DDS LLC
Entity type:Organization
Organization Name:SAVANNAH BUDDE DDS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAVANNAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BUDDE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-753-4780
Mailing Address - Street 1:99 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AMELIA
Mailing Address - State:OH
Mailing Address - Zip Code:45102-1737
Mailing Address - Country:US
Mailing Address - Phone:513-753-4780
Mailing Address - Fax:
Practice Address - Street 1:99 W MAIN ST
Practice Address - Street 2:
Practice Address - City:AMELIA
Practice Address - State:OH
Practice Address - Zip Code:45102-1737
Practice Address - Country:US
Practice Address - Phone:513-720-9934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1043894629OtherNPI
OH1386699312OtherNPI