DAYTON SKIN SURGERY CENTER INC – MOHS-Micrographic Surgery Physician, NPI 1710932454

DAYTON SKIN SURGERY CENTER INC is a healthcare provider. based in Dayton, Ohio. specializing in MOHS-Micrographic Surgery Physician. The organization holds a License No. 35073167 (OH). The NPI Number for DAYTON SKIN SURGERY CENTER INC is 1710932454

Main info

Organization
Name
DAYTON SKIN SURGERY CENTER INC
NPI
1710932454
Phone
(937) 293-5567
Address
3025 GOVERNORS PLACE BLVD
Authorized Official
DR. HEIDI B DONNELLY OWNER MD
Enumeration Date
23 May 2006
Last Update Date
2 June 2010
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for DAYTON SKIN SURGERY CENTER INC

  • 3025 GOVERNORS PLACE BLVD

    DAYTON, OH 454091330

    Phone: (937) 293-5567

    Fax: (937) 293-5568

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-07-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20060719000087OClinic/Group PracticeOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 45409)

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Reviews

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Frequently asked questions

Is DAYTON SKIN SURGERY CENTER INC listed with a National Provider Identifier?
Yes — DAYTON SKIN SURGERY CENTER INC has NPI 1710932454 on file in the registry.
Active or inactive — what applies to DAYTON SKIN SURGERY CENTER INC?
You should see DAYTON SKIN SURGERY CENTER INC as active in CMS-hosted NPPES data.
What kind of doctor is DAYTON SKIN SURGERY CENTER INC?
DAYTON SKIN SURGERY CENTER INC is associated with MOHS-Micrographic Surgery Physician in the directory — Clinical services aligned with this taxonomy classification.
Is DAYTON SKIN SURGERY CENTER INC associated with Dayton?
Public fields place DAYTON SKIN SURGERY CENTER INC around Dayton, Ohio. Always confirm the exact site before visiting.
Can I trust this NPI listing for DAYTON SKIN SURGERY CENTER INC?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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DAVID SURPRENANT

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3025 Governors Place Blvd
NPI: 1265895932