Banahan, Jackie L
Banahan, Jackie L is an sole proprietor health care provider with primary practice located at 3141 Beaumont Centre Cir Suite 100, Lexington KY 40513-1934. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Banahan, Jackie L can be contacted via phone (859) 223-4888.Contact Information
Primary practice address
3141 Beaumont Centre Cir Suite 100
Lexington KY 40513-1934
Phone: (859) 223-4888
Fax: (859) 296-4688
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 4977 | Kentucky |
Profile Details
| NPI number | 1093866154 |
|---|---|
| LBN Legal business name | Banahan, Jackie L |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 16th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093866154 | NPPES |
| Kentucky | MEDICAID | 60049772 |
Popular Providers
-
Bimstein, Enrique
740 S Limestone University Of Kentucky College Of Dentistry, Lexington KY 40536-0284 -
Stigers, Jenny I
800 Rose St D104, Lexington KY 40536-0297 -
Singer, Ronald Lee
740 S Limestone Uk College Of Dentistry Ste A219 , Lexington KY 40536-4495 -
Haney, Charlotte A
800 Rose Street Rm D104 University Of Kentucky College Of Dentistry, Lexington KY 40536-0297 -
Turner, Erwin G
A-218 Kentucky Clinic , Lexington KY 40536-0284 -
Van Meter, Wendy Humphrey
181 W Lowry Ln Suite 110, Lexington KY 40503-3016 -
Robinette, Catherine Dana
216 Fountain Ct Suite#150, Lexington KY 40509-1888 -
Steckler, Daniel John
Ky Clinic Dentistry Room A-219, Lexington KY 40536-0001