Provider Demographics
NPI:1053486217
Name:BURCHETT, ROBIN LEIGH (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:LEIGH
Last Name:BURCHETT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ROBIN
Other - Middle Name:LEIGH
Other - Last Name:BAYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1393 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-2047
Mailing Address - Country:US
Mailing Address - Phone:859-254-9267
Mailing Address - Fax:859-231-0372
Practice Address - Street 1:1393 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-2047
Practice Address - Country:US
Practice Address - Phone:859-254-9267
Practice Address - Fax:859-231-0372
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY71661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice