Healthcare Provider Details

I. General information

NPI: 1639192289
Provider Name (Legal Business Name): CALLEY JO PERRY DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CALLEY JO PERRY DMD

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 S MAIN ST
DRY RIDGE KY
41035-7343
US

IV. Provider business mailing address

PO BOX 23012
LEXINGTON KY
40523-3012
US

V. Phone/Fax

Practice location:
  • Phone: 859-785-5717
  • Fax:
Mailing address:
  • Phone: 859-785-5717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number7742
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number7742
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number9158
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: