# 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:** 1821248162
- **Legal business name:** DENTAL SERVICES OF KENTUCKY, PSC
- **Authorized official:** AMY WHEELER (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (913) 800-6952

## Contact information

- **Practice address:** 2358 NICHOLASVILLE RD, \#156, LEXINGTON, KY 40503-3032
- **Practice address phone:** (859) 381-0680
- **Practice address fax:** (859) 381-0633
- **Mailing address:** PO BOX 11568, STE 155, OVERLAND, KS 66207-4268
- **Mailing address phone:** (913) 428-1674
- **Mailing address fax:** (866) 591-0604

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 09/23/2008
- **Last updated:** 04/12/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7100058850 | — | KY |