Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Independent Provider

Organization Preferred Provider Organization · NPI 1699178723

Independent Provider is a Preferred Provider Organization in Dayton, Ohio. Registered with an NPI since 2014.

In the registry since
2014

Practice location Address checks out

5659 Troy Villa Blvd
Dayton, OH 45424-2645
Phone: (979) 451-3843
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Preferred Provider Organization (primary) Taxonomy 305R00000X

Record details

NPI number1699178723
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official La'Tasha Lee — Independent Provider · (979) 451-3843
NPI enumeratedOctober 3, 2014
Last updated in NPPESOctober 3, 2014
Mailing address5659 Troy Villa Blvd, Dayton, OH 45424-2645

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