Provider Demographics
NPI:1477846780
Name:RALEIGH, JOSHUA RAY (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:RAY
Last Name:RALEIGH
Suffix:
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 1:308 HAMBLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-1275
Mailing Address - Country:US
Mailing Address - Phone:606-432-2773
Mailing Address - Fax:
Practice Address - Street 1:308 HAMBLEY BLVD
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1275
Practice Address - Country:US
Practice Address - Phone:606-432-2773
Practice Address - Fax:606-644-0265
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY90431223P0221X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist