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Contact Information

ABCDENTISTRY
5316 S 3RD ST
LOUISVILLE, KY40214
 Phone: 502-643-0560
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Dental

261QD0000X
Indicates primary specialty

NPI Profile & details for ABCDENTISTRY · (Female)

NPI # 1477058659
Status Active
Credentials
Entity Individual
Enumeration date 03/28/2018
Last updated 08/01/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • KY License # 8651
  • KY Medicaid 7100146420
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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