Individual
DR. WENDY STAVRIDES HUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
501 S PRESTON ST, LOUISVILLE, KY 40202-1701
(502) 852-6353
(502) 852-1220
Mailing address
7208 WOOLRICH RD, LOUISVILLE, KY 40222-6527
(502) 429-3834
(502) 852-1220
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
24173
PA
1223G0001X
General Practice Dentistry
Primary
8535
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50017591
PASSPORT HEALTH PLAN
KY
05
—
7100017440
—
KY
01
—
9202491
DORAL DENTAL
KY
Enumeration date
06/15/2005
Last updated
04/14/2008
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