Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | 8238 | KY |
N | 1223G0001X | General Practice | 8238 | KY |
N | 213EG0000X | General Practice | 8238 | KY |
Y | 1223P0221X | Pediatric Dentist | 8238 | KY |
NPI | 1104918945 |
---|---|
Provider Name | Dr. Kelly J Dingrando |
First Address | Lexington, KY 40536-0297 |
Second Address | Lexington, KY 40536 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 02/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100006880 | (05) | KY |