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General NPI Number Information
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NPI Number | 1003224593
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Entity Type | Individual
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Provider Name | JEFFREY HEDGES DMD
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Gender | Male
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Dates
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Enumeration Date | 07/28/2014
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 2015 HERR LN STE D
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City | LOUISVILLE
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State | KY
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Zip | 40222-6567
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Country | US
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Telephone | 502-767-7379
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Fax |
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Provider Business Mailing Address
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Address Line | 5714 SUGAR BERRY LN
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-6625
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Country | US
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Telephone | 502-767-7379
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12012179A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9534
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License Number State | KY
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