MEDICARE: DR. PATTY V ADAMS DMD PSC

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	05771	KY

General Provider Information

NPI Number	:	1629156864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATTY V ADAMS DMD PSC

Provider Business Mailing Address
First Line	:	2821 SOUTH HURSTBOURNE PKWY
Second Line	:	STE 7
City	:	LOUISVILLE
State	:	KY
Zip	:	40220
Country	:	US
Telephone Number	:	502-493-8218
Fax Number	:

Provider Business Practice Location Address
First Line	:	2821 SOUTH HURSTBOURNE PKWY
Second Line	:	STE 7
City	:	LOUISVILLE
State	:	KY
Zip	:	40220
Country	:	US
Telephone Number	:	502-493-8218
Fax Number	:

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

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	12/28/2025

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