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Contact Information

MITISHA N MARTIN, DMD
5316 S. 3RD STREET
LOUISVILLE, KY40214
 Phone: 502-276-8778
 Fax:
 Website: http://www.sparkleandshinedental.com
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for MITISHA N MARTIN · (Female)

NPI # 1255592267
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 06/23/2008
Last updated 07/14/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • KY License # 8651
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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