Provider Demographics
NPI:1730527102
Name:PETER J. AHN, D.D.S., LLC
Entity type:Organization
Organization Name:PETER J. AHN, D.D.S., LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:JUNSUN
Authorized Official - Last Name:AHN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-426-4554
Mailing Address - Street 1:5274 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-4781
Mailing Address - Country:US
Mailing Address - Phone:614-426-4554
Mailing Address - Fax:614-426-4556
Practice Address - Street 1:5274 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-4781
Practice Address - Country:US
Practice Address - Phone:614-426-4554
Practice Address - Fax:614-426-4556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty