MEDICARE: ALBERT E BATHIANY IV DMD

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	1223P0221X	Pediatric Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730364761
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALBERT E BATHIANY IV DMD

Provider Business Mailing Address
First Line	:	18 N FORT THOMAS AVE
Second Line	:
City	:	FORT THOMAS
State	:	KY
Zip	:	41075-3098
Country	:	US
Telephone Number	:	859-781-4100
Fax Number	:	859-781-0170

Provider Business Practice Location Address
First Line	:	18 N FORT THOMAS AVE
Second Line	:
City	:	FORT THOMAS
State	:	KY
Zip	:	41075-3098
Country	:	US
Telephone Number	:	859-781-4100
Fax Number	:	859-781-0170

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BERT E BATHIANY IV
Credential	:	DMD
Telephone Number	:	859-781-4100

Provider Enumeration Date	:	01/09/2008
Last Update Date	:	01/09/2008

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