Healthcare Provider Details

I. General information

NPI: 1649198284
Provider Name (Legal Business Name): WESTERN KENTUCKY PEDIATRIC DENTISTRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 N 7TH ST
MAYFIELD KY
42066-1820
US

IV. Provider business mailing address

PO BOX N
MAYFIELD KY
42066-0019
US

V. Phone/Fax

Practice location:
  • Phone: 606-802-6191
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ALLISON HIGGINS MILLS
Title or Position: OWNER/PEDIATRIC DENTIST
Credential: DMD, MS
Phone: 606-802-6191