Provider Demographics
NPI:1275966996
Name:HILLIARD, EMILY KAY (DMD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:KAY
Last Name:HILLIARD
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 1:810 WASHBURN AVE
Mailing Address - Street 2:UNIT 38
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-6794
Mailing Address - Country:US
Mailing Address - Phone:270-792-4214
Mailing Address - Fax:
Practice Address - Street 1:134 EVERGREEN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1487
Practice Address - Country:US
Practice Address - Phone:502-244-9595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9259122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist