Healthcare Provider Details

I. General information

NPI: 1588599575
Provider Name (Legal Business Name): ABIGAIL ROSE FAULKNER DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABIGAIL ROSE HACKER

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7303 US HIGHWAY 42
FLORENCE KY
41042-1903
US

IV. Provider business mailing address

243 EDWARDS AVE
WALTON KY
41094-1085
US

V. Phone/Fax

Practice location:
  • Phone: 859-848-7994
  • Fax:
Mailing address:
  • Phone: 240-243-3767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD-00239
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: