Provider Demographics
NPI:1487970232
Name:WEISENBERGER, MEGAN JO (DMD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:JO
Last Name:WEISENBERGER
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 1:6932 MIAMI BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-3070
Mailing Address - Country:US
Mailing Address - Phone:513-708-8997
Mailing Address - Fax:
Practice Address - Street 1:1017 DELTA AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208
Practice Address - Country:US
Practice Address - Phone:513-321-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-18
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH300240831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice