Provider Demographics
NPI:1033859897
Name:DUNLAP, VIRGINIA M (DMD)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:M
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 MAYSVILLE RD STE B
Mailing Address - Street 2:
Mailing Address - City:MOUNT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-9767
Mailing Address - Country:US
Mailing Address - Phone:859-404-7686
Mailing Address - Fax:859-274-4459
Practice Address - Street 1:635 MAYSVILLE RD STE B
Practice Address - Street 2:
Practice Address - City:MOUNT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-9767
Practice Address - Country:US
Practice Address - Phone:859-498-1215
Practice Address - Fax:859-498-7314
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KY107761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program