Provider Demographics
NPI:1275783870
Name:PIKE COUNTY HEALTH DEPARTMENT-DENTAL
Entity Type:Organization
Organization Name:PIKE COUNTY HEALTH DEPARTMENT-DENTAL
Other - Org Name:PIKE COUNTY HEALTH DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR II
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:M
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-437-5000
Mailing Address - Street 1:119 RIVER DR
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-1685
Mailing Address - Country:US
Mailing Address - Phone:606-437-5500
Mailing Address - Fax:
Practice Address - Street 1:119 RIVER DR
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1685
Practice Address - Country:US
Practice Address - Phone:064-375-5000
Practice Address - Fax:606-433-9690
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PIKE COUNTY HEALTH DEPARTMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-19
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYFLU0090Medicare PIN