# DENTAL SERVICES OF KENTUCKY, PSC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DENTAL SERVICES OF KENTUCKY, PSC
- **Other names:** ImmediaDent
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1164672283
- **Legal business name:** DENTAL SERVICES OF KENTUCKY, PSC
- **Authorized official:** AMY WHEELER (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (913) 800-6952

## Contact information

- **Practice address:** 3101 RICHMOND RD., SUITE 307, LEXINGTON, KY 40509-9770
- **Practice address phone:** (859) 963-2342
- **Practice address fax:** (913) 800-6967
- **Mailing address:** PO BOX 11568, OVERLAND PARK, KS 66207-4268
- **Mailing address phone:** (913) 428-1674
- **Mailing address fax:** (913) 800-6967

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 09/25/2008
- **Last updated:** 04/12/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7100245080 | — | KY |