=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649198284
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WESTERN KENTUCKY PEDIATRIC DENTISTRY, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/09/2026
-----------------------------------------------------
Last Update Date | 07/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 212 N 7TH ST
-----------------------------------------------------
City | MAYFIELD
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42066-1820
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-802-6191
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX N
-----------------------------------------------------
City | MAYFIELD
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42066-0019
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PEDIATRIC DENTIST
-----------------------------------------------------
Name | DR. ALLISON HIGGINS MILLS
-----------------------------------------------------
Credential | DMD, MS
-----------------------------------------------------
Telephone | 606-802-6191
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0221X
-----------------------------------------------------
Taxonomy Name | Pediatric Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------