Healthcare Provider Details

I. General information

NPI: 1043655392
Provider Name (Legal Business Name): EMILEE YOUNG SEXTON DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2013
Last Update Date: 03/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2549 SUN SEEKER CT
LEXINGTON KY
40503-2980
US

IV. Provider business mailing address

2340 THISTLE PARK
LEXINGTON KY
40509-8568
US

V. Phone/Fax

Practice location:
  • Phone: 606-465-1641
  • Fax:
Mailing address:
  • Phone: 606-465-1641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number9326
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: