Healthcare Provider Details

I. General information

NPI: 1063728285
Provider Name (Legal Business Name): JEREMY F BELL D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2010
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1072 BARNES MILL RD
RICHMOND KY
40475-8729
US

IV. Provider business mailing address

301 JACKSON ST
BEREA KY
40403-1719
US

V. Phone/Fax

Practice location:
  • Phone: 859-353-3004
  • Fax:
Mailing address:
  • Phone: 801-830-3011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN03484
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN10000891
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD-00173
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number010349
License Number StateCT
# 5
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number6001127-15
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: