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ADVANCED DERMATOLOGY OF OHIO, INC
NPI 1760491401
Dermatology in Mason, OH

Active since August 05, 2006CLIA 36D2136485 · Accreditation
4834 SOCIALVILLE FOSTER RD STE 20, MASON, OH 45040(513) 459-1988 Get Directions Write a Review

NPPES record last updated: October 25, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Advanced Dermatology Of Ohio, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADVANCED DERMATOLOGY OF OHIO, INC (NPI 1760491401) is a healthcare organization registered as a dermatology in Mason, Ohio and active in the NPI registry since August 2006. The organization holds an CLIA Accreditation certificate valid through September 4, 2027, maintains a secondary practice location in Beavercreek, and lists Amy E Declue, Director, Provider Services, as its authorized official.

NPPES Registry Identity

NPI1760491401
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameADVANCED DERMATOLOGY OF OHIO, INC
Location Address4834 SOCIALVILLE FOSTER RD STE 20Mason, OH 45040-6827
Mailing Address151 Southhall Ln, Ste 300Maitland, FL 32751-7176 · (407) 875-2080 · Fax (407) 650-3455
Phone(513) 459-1988
Organization SubpartNo
Authorized OfficialAmy E DeclueDirector, Provider Services · (407) 875-2080
Enumeration DateAugust 5, 2006
Last NPPES UpdateOctober 25, 2023
NPPES CertifiedOctober 25, 2023
✔ NPI 1760491401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
4834 SOCIALVILLE FOSTER RD STE 20, Mason, OH 45040
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Secondary Practice Location 1

Location 12361 Lakeview Dr Unit 2361Beavercreek, OH 45431-3695 · Phone (937) 306-0200

Other Identifiers 1

Medicaid2531406OH

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Molina Healthcare.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 36D2136485

Advanced Dermatology Of Ohio · Mason, OH
Active · expires Sep 4, 2027
CLIA Number36D2136485
Laboratory TypePhysician Office
Certificate Effective DateSeptember 5, 2025
Certificate Expiration DateSeptember 4, 2027
Laboratory DirectorKeoni Nguyen
Laboratory Phone(513) 459-1988
Laboratory LocationAdvanced Dermatology Of Ohio4834 Socialville Foster Road, Ste 20, Mason, OH 45040
CLIA data matches this NPI record on: Address Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. LAUREN CHURCHEY FNP-C
Nurse Practitioner (Family)
4834 SOCIALVILLE FOSTER RD STE 20
MASON, OH 45040
Warren County (513) 459-1988

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Advanced Dermatology Of Ohio, Inc's NPI number?

The NPI number for Advanced Dermatology Of Ohio, Inc is 1760491401. It was assigned to this organization in the NPPES registry on August 5, 2006.

Where is Advanced Dermatology Of Ohio, Inc located?

Advanced Dermatology Of Ohio, Inc is located at 4834 Socialville Foster Rd Ste 20, Mason, OH 45040. The listed phone number is (513) 459-1988.

What is Advanced Dermatology Of Ohio, Inc's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Advanced Dermatology Of Ohio, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 36D2136485) is associated with this NPI, valid through September 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Advanced Dermatology Of Ohio, Inc accept?

Health plans from Anthem Blue Cross and Blue Shield and Molina Healthcare list Advanced Dermatology Of Ohio, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Advanced Dermatology Of Ohio, Inc was last updated on October 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.