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NPI Code Detail

MEDICARE: SEBASTIAN ORTHODONTICS PLLC

MEDICARE: SEBASTIAN ORTHODONTICS PLLC
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
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number : 1356271571
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEBASTIAN ORTHODONTICS PLLC
Provider Business Mailing Address
First Line : 2474 SHELBYVILLE RD
Second Line :
City : SHELBYVILLE
State : KY
Zip : 40065-9118
Country : US
Telephone Number : 502-513-5200
Fax Number :
Provider Business Practice Location Address
First Line : 2474 SHELBYVILLE RD
Second Line :
City : SHELBYVILLE
State : KY
Zip : 40065-9118
Country : US
Telephone Number : 502-513-5200
Fax Number :
Authorized Official
Title or Position : ORTHODONTIST
Name : LEAH SEBASTIAN
Credential : DMD
Telephone Number : 502-513-5200
Provider Enumeration Date : 05/20/2026
Last Update Date : 05/20/2026

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