Provider Demographics
NPI:1154828176
Name:SCHULTEN PEDIATRIC DENTISTRY FRANKFORT LLC
Entity Type:Organization
Organization Name:SCHULTEN PEDIATRIC DENTISTRY FRANKFORT LLC
Other - Org Name:FRANKFORT PEDIATRIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCHULTEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:502-223-7186
Mailing Address - Street 1:98 C MICHAEL DAVENPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-4333
Mailing Address - Country:US
Mailing Address - Phone:502-223-7186
Mailing Address - Fax:502-223-2514
Practice Address - Street 1:98 C MICHAEL DAVENPORT BLVD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-4333
Practice Address - Country:US
Practice Address - Phone:502-223-7186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-06
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY88681223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty