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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

NPI Number 1477058659
LBN Legal business name ABCDENTISTRY
Authorized official MITISHA MARTIN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/28/2018
Last updated 08/01/2018 - About 8 years ago
Identifiers
KY License # 8651
KY Medicaid 7100146420
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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