| Immediadent | |
|
3101 Richmond Rd. Suite 307 Lexington KY 40509-9770 | |
| (859) 963-2342 | |
| (913) 800-6967 |
| Full Name | Immediadent |
|---|---|
| Speciality | Dentist |
| Location | 3101 Richmond Rd., Lexington, Kentucky |
| Authorized Official Name and Position | Amy Wheeler (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 9138006952 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Immediadent Po Box 11568 Overland Park KS 66207-4268 Ph: (913) 428-1674 | Immediadent 3101 Richmond Rd. Suite 307 Lexington KY 40509-9770 Ph: (859) 963-2342 |
| NPI Number | 1164672283 |
|---|---|
| Provider Enumeration Date | 09/25/2008 |
| Last Update Date | 04/12/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164672283 | NPI | - | NPPES |
| 7100245080 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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