Healthcare Provider Details

I. General information

NPI: 1417107616
Provider Name (Legal Business Name): MEGAN MCHUGH DMD, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2008
Last Update Date: 05/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3141 BEAUMONT CENTRE CIR STE 200
LEXINGTON KY
40513-1956
US

IV. Provider business mailing address

3141 BEAUMONT CENTRE CIR STE 200
LEXINGTON KY
40513-1956
US

V. Phone/Fax

Practice location:
  • Phone: 859-296-4846
  • Fax: 859-296-2842
Mailing address:
  • Phone: 859-296-4846
  • Fax: 859-296-2842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number8414
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number861
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: