Individual
DR. REGAN WIESEMANN ACKERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
7600 OUTER LOOP, LOUISVILLE, KY 40228-1729
(502) 231-9970
Mailing address
7600 OUTER LOOP, LOUISVILLE, KY 40228-1729
(502) 231-9970
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8470
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208018897
TAX ID FOR MORTENSON FAMILY DENTAL (EMPLOYMENT ENDED 1/31/12)
KY
01
—
454214024
BUSINESS TAX ID FOR ACKERMAN FAMILY DENTAL
KY
Enumeration date
06/18/2007
Last updated
01/29/2012
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