MEDICARE: MRS. SARA SCHMIDT CUMMINS D.M.D

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
1	1223G0001X	General Practice Dentistry	7962	KY

General Provider Information

NPI Number	:	1558485060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARA SCHMIDT CUMMINS D.M.D

Provider Business Mailing Address
First Line	:	6007 TIMBER RIDGE DR
Second Line	:
City	:	PROSPECT
State	:	KY
Zip	:	40059-8134
Country	:	US
Telephone Number	:	502-228-4700
Fax Number	:	502-228-4797

Provider Business Practice Location Address
First Line	:	6007 TIMBER RIDGE DR
Second Line	:
City	:	PROSPECT
State	:	KY
Zip	:	40059-8134
Country	:	US
Telephone Number	:	502-228-4700
Fax Number	:	502-228-4797

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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