Healthcare Provider Details

I. General information

NPI: 1467266700
Provider Name (Legal Business Name): KAREN ANNE HUGHES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2025
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 EASTBROOKE POINTE DR STE 115
MOUNT WASHINGTON KY
40047-5561
US

IV. Provider business mailing address

393 EASTBROOKE POINTE DR STE 115
MOUNT WASHINGTON KY
40047-5561
US

V. Phone/Fax

Practice location:
  • Phone: 502-538-0505
  • Fax: 502-220-4733
Mailing address:
  • Phone: 502-538-0505
  • Fax: 502-220-4733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. KAREN HUGHES
Title or Position: OWNER
Credential: DMD
Phone: 505-538-0505