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Contact Information

BENNIE B ALDERDICE SR, DMD
100 HARDIN LN
SUITE B
SOMERSET, KY42503-3812
 Phone: 606-679-8568
 Fax: 606-676-0868
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral & Maxillofacial Surgery

204E00000X 02 Physician/General Surgery
 

Dentist

122300000X
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
Indicates primary specialty

NPI Profile & details for BENNIE B ALDERDICE SR · (Male)

NPI Number 1518973478
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 07/31/2006
Last updated 12/27/2017 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • KY License # 4939
  • KY Medicaid 60049392
  • KY Medicaid 64049398
  • KY Other 000000048337 ANTHEM BC/BS
  • KY Other 5004539 PASSPORT
  • KY Other 63437-1 UNITED HEALTHCARE DENTAL
  • KY Other 4300039 UNITED HEALTHCARE MEDICAL
  • TN Other 0041586 BC/BS OF TN.
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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