Healthcare Provider Details

I. General information

NPI: 1922930825
Provider Name (Legal Business Name): MADISON ANNE LITTLE DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1508 OXFORD DR STE 2
GEORGETOWN KY
40324-9266
US

IV. Provider business mailing address

2925 COMBS FERRY RD
WINCHESTER KY
40391-9769
US

V. Phone/Fax

Practice location:
  • Phone: 502-735-0219
  • Fax:
Mailing address:
  • Phone: 606-275-0299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD-00215
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: