Provider Demographics
NPI:1699800649
Name:ALEX G. CASSINELLI, D.M.D., INC.
Entity type:Organization
Organization Name:ALEX G. CASSINELLI, D.M.D., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:CASSINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:513-777-7060
Mailing Address - Street 1:7242 TYLERS CORNER DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-6334
Mailing Address - Country:US
Mailing Address - Phone:513-777-7060
Mailing Address - Fax:513-777-0716
Practice Address - Street 1:7242 TYLERS CORNER DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6334
Practice Address - Country:US
Practice Address - Phone:513-777-7060
Practice Address - Fax:513-777-0716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH202411223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty