Provider Demographics
NPI:1295848802
Name:DEPP, ANSLEY H (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANSLEY
Middle Name:H
Last Name:DEPP
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 1:2600 ALEXANDRIA PIKE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:KY
Mailing Address - Zip Code:41076-1590
Mailing Address - Country:US
Mailing Address - Phone:859-442-8200
Mailing Address - Fax:859-442-9555
Practice Address - Street 1:2600 ALEXANDRIA PIKE
Practice Address - Street 2:
Practice Address - City:HIGHLAND HEIGHTS
Practice Address - State:KY
Practice Address - Zip Code:41076-1590
Practice Address - Country:US
Practice Address - Phone:859-442-8200
Practice Address - Fax:859-442-9555
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY067511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice