# DENTAL WELLNESS OF LEXINGTON

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992718340
- **Authorized official:** MRS. MANDY WALLIN (OFFICE MANAGER)
- **Authorized official phone:** (859) 223-4644

## Contact information

- **Practice address:** 527 WELLINGTON WAY, SUITE 120, LEXINGTON, KY 40503
- **Practice address phone:** (859) 223-4644
- **Practice address fax:** (859) 224-8466
- **Mailing address:** 527 WELLINGTON WAY, SUITE 120, LEXINGTON, KY 40503
- **Mailing address phone:** (859) 223-4644
- **Mailing address fax:** (859) 224-8466

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 55800 | KY | Yes |
| 122300000X | Dentist | 8009 | KY | — |

## Other

- **Enumeration date:** 08/15/2006
- **Last updated:** 05/09/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000806082 | UNITED CONCORDIA | — |
| 01 | — | 333276 | BCBS OF KY FEDERAL | — |