Sparkle And Shine Family Dental
LBN: Abcdentistry
Sparkle And Shine Family Dental is an health care organization with primary practice located at 5316 S 3Rd St , Louisville KY 40214. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Ambulatory Health Care Facilities / Dental. Dental Providers / General Practice is the primary health care specialty.
Abcdentistry can be contacted via phone (502) 643-0560, or through Martin, Mitisha via phone (502) 276-8778.
Contact Information
Primary practice address
5316 S 3Rd St
Louisville KY 40214
Phone: (502) 643-0560
Fax:
Website:
Authorized official contact:
Name: Martin, Mitisha Doctor of Dental Medicine (DMD)
Phone: (502) 276-8778
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 8651 | Kentucky |
| Ambulatory Health Care Facilities / Dental | 261QD0000X | 8651 | Kentucky |
Profile Details
| NPI number | 1477058659 |
|---|---|
| LBN Legal business name | Abcdentistry |
| DBA Doing business as | Sparkle And Shine Family Dental |
| Authorized official | Martin, Mitisha Doctor of Dental Medicine (DMD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 28th, 2018 |
| Last updated | Aug 1st, 2018 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477058659 | NPPES |
| Kentucky | MEDICAID | 7100146420 |
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