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NPI Code Detail

MEDICARE: LAUREN TAYLOR LITTLE DMD

MEDICARE: LAUREN TAYLOR LITTLE DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program10590KY
21223G0001XGeneral Practice Dentistry10590KY
31223P0221XPediatric Dentistry10590KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110590OTHERKYKENTUCKY BOARD OF DENTISTRY LICENSE

General Provider Information

NPI Number : 1881269777
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN TAYLOR LITTLE DMD
Provider Business Mailing Address
First Line : 2925 COMBS FERRY RD
Second Line :
City : WINCHESTER
State : KY
Zip : 40391-9769
Country : US
Telephone Number : 606-275-1339
Fax Number :
Provider Business Practice Location Address
First Line : 1508 OXFORD DR STE 2
Second Line :
City : GEORGETOWN
State : KY
Zip : 40324-9266
Country : US
Telephone Number : 27-350-2195
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2021
Last Update Date : 07/05/2023

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