Provider Demographics
NPI:1437346780
Name:DESIGNING SMILES
Entity Type:Organization
Organization Name:DESIGNING SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SANDIFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-226-1900
Mailing Address - Street 1:630 COMANCHE TR
Mailing Address - Street 2:STE A
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601
Mailing Address - Country:US
Mailing Address - Phone:502-226-1900
Mailing Address - Fax:502-226-1990
Practice Address - Street 1:630 COMANCHE TR
Practice Address - Street 2:STE A
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601
Practice Address - Country:US
Practice Address - Phone:502-226-1900
Practice Address - Fax:502-226-1990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8429122300000X
KY5876122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60058765Medicaid