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Organization
IRVINE FAMILY DENTISTRY
Active
Organization
IRVINE FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON W GAY DMD (DENTIST PRESIDENT OWNER)
(606) 723-1000
Entity
Organization
Contact information
Practice address
934 RICHMOND RD, IRVINE, KY 40336-7230
(606) 723-1000
(606) 723-1039
Mailing address
934 RICHMOND RD, IRVINE, KY 40336-7230
(606) 723-1000
(606) 723-1039
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7138
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61943775
—
KY
01
—
ANTHEM
ANTHEM PROVIDER NUMBER
KY
Enumeration date
12/28/2006
Last updated
08/22/2020
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