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Individual

DR. WILLIAM R. ALLEN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
2120 HIGH WICKHAM PL STE 103, LOUISVILLE, KY 40245-5903
(502) 512-0143
(502) 512-0129
Mailing address
2800 CANNONS LN, STE 100, LOUISVILLE, KY 40205
(502) 454-4885
(502) 452-1926

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
8471
KY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
8471
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
8471
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000770334
ANTHEM
KY
05
201098860
IN
05
7100210090
KY
05
7100210290
KY
01
P01500682
RAILROAD MEDICARE
KY
Enumeration date
07/19/2009
Last updated
02/20/2026
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