National Provider Identifier Database

KENTUCKY CENTER FOR ORAL MAXILLOFACIAL SURGERY
Oral & Maxillofacial Surgery


Contact Information

KENTUCKY CENTER FOR ORAL & MAXILLOFACIAL SURGERY
3159 BEAUMONT CENTRE CIRCLE
SUITE 110
LEXINGTON, KY40513-1934
Phone: 859-278-9376
Fax: 859-276-0260
Website:
Specialty Taxonomy Code
* Oral & Maxillofacial Surgery 204E00000X

* Indicates primary specialty

NPI Profile & details for KENTUCKY CENTER FOR ORAL & MAXILLOFACIAL SURGERY

NPI Number 1053453043
Legal business name
LBN
KENTUCKY CENTER FOR ORAL & MAXILLOFACIAL SURGERY
Authorized official REDA VAUGHN - (OFFICE MANAGER)
Entity Organization
Organization subpart No
Enumeration date 02/13/2007
Last updated 09/29/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • KY Medicaid: 7100182480

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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