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NPI Code Detail

MEDICARE: DENTAL HEALTH PROFESSIONALS OF KENTUCKY, P.S.C.

MEDICARE: DENTAL HEALTH PROFESSIONALS OF KENTUCKY, P.S.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1013690809
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTAL HEALTH PROFESSIONALS OF KENTUCKY, P.S.C.
Provider Business Mailing Address
First Line : 7704 BARDSTOWN RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40291-3207
Country : US
Telephone Number : 502-200-5220
Fax Number :
Provider Business Practice Location Address
First Line : 7704 BARDSTOWN RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40291-3207
Country : US
Telephone Number : 502-200-5220
Fax Number :
Authorized Official
Title or Position : CREDENTIALING COORDINATOR
Name : BELINDA HUERTA
Credential :
Telephone Number : 217-540-2100
Provider Enumeration Date : 08/09/2023
Last Update Date : 08/09/2023

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Directions to “DENTAL HEALTH PROFESSIONALS OF KENTUCKY, P.S.C. ” Practice Location

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