Provider Demographics
NPI:1558243428
Name:BRICENO, ORNELA V (DDS,MSC)
Entity type:Individual
Prefix:
First Name:ORNELA
Middle Name:V
Last Name:BRICENO
Suffix:
Gender:F
Credentials:DDS,MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 OLENTANGY MEADOWS DR STE 319
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-0230
Mailing Address - Country:US
Mailing Address - Phone:913-275-1350
Mailing Address - Fax:
Practice Address - Street 1:2045 POSTLE HALL 305 W. 12TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210
Practice Address - Country:US
Practice Address - Phone:614-292-5398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-22
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRES.004996122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist