Individual
DR. FAHED BASEM HISHMEH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
650 N MAIN ST, MONTICELLO, KY 42633-1536
(606) 348-5100
(606) 348-4849
Mailing address
650 N MAIN ST, MONTICELLO, KY 42633-1536
(606) 348-5100
(606) 348-4849
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7403
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45003571
PRIOR AUTH.# FOR MEDICAID
KY
05
—
60000098
—
KY
Enumeration date
07/27/2006
Last updated
08/28/2012
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