Provider Demographics
NPI:1679457683
Name:CINCINNATI DERMATOLOGY INSTITUTE
Entity type:Organization
Organization Name:CINCINNATI DERMATOLOGY INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:DENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELKEEB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-400-4781
Mailing Address - Street 1:6552 COPPERLEAF LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-2444
Mailing Address - Country:US
Mailing Address - Phone:513-400-4781
Mailing Address - Fax:
Practice Address - Street 1:6552 COPPERLEAF LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-2444
Practice Address - Country:US
Practice Address - Phone:513-400-4781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center