Bogardus, Amy Jane

Bogardus, Amy Jane is an individual health care provider with primary practice located at 400 S 4Th St , Danville KY 40422-2007. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is her primary health care specialty. Bogardus, Amy Jane can be contacted via phone (859) 236-1130.

Contact Information

Primary practice address
400 S 4Th St Danville KY 40422-2007
Phone: (859) 236-1130
Fax: (859) 239-9384
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 6874 Kentucky
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 6874 Kentucky

Profile Details

NPI number 1558325878
LBN Legal business name Bogardus, Amy Jane
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2006
Last updated Jan 15th, 2014 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558325878 NPPES
Kentucky MEDICAID 64026313
Kentucky MEDICAID 60068749

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