Healthcare Provider Details

I. General information

NPI: 1699686477
Provider Name (Legal Business Name): YAZMIN ORTIZ VERDECIA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9031 US HIGHWAY 42 STE A
UNION KY
41091-7196
US

IV. Provider business mailing address

1911 PROMENADE CIR APT 1136
UNION KY
41091-8835
US

V. Phone/Fax

Practice location:
  • Phone: 859-403-3382
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD-00284
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: