<Unavail>

LBN: Abcdentistry
<Unavail> is an health care organization with primary practice located at 5316 S 3Rd St , Louisville KY 40214. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Ambulatory Health Care Facilities / Dental. Dental Providers / General Practice is the primary health care specialty. Abcdentistry can be contacted via phone (502) 643-0560, or through Martin, Mitisha via phone (502) 276-8778.

Contact Information

Primary practice address
5316 S 3Rd St Louisville KY 40214
Phone: (502) 643-0560
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Martin, Mitisha Doctor of Dental Medicine (DMD)
Phone: (502) 276-8778

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 8651 Kentucky
Ambulatory Health Care Facilities / Dental 261QD0000X 8651 Kentucky

Profile Details

NPI number 1477058659
LBN Legal business name Abcdentistry
DBA Doing business as <Unavail>
Authorized official Martin, Mitisha Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 28th, 2018
Last updated Aug 1st, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477058659 NPPES
Kentucky MEDICAID 7100146420

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