Provider Demographics
NPI:1467528257
Name:BATHIANY, ALBERT IV (DMD)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:
Last Name:BATHIANY
Suffix:IV
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 HWY 42
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042
Mailing Address - Country:US
Mailing Address - Phone:859-525-2100
Mailing Address - Fax:859-525-0656
Practice Address - Street 1:7400 HWY 42
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042
Practice Address - Country:US
Practice Address - Phone:859-525-2100
Practice Address - Fax:859-525-0656
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5180 SPECIALTY 3701223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY61941787Medicaid
KY60051802Medicaid