Provider Demographics
NPI:1558485060
Name:CUMMINS, SARA SCHMIDT (DMD)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:SCHMIDT
Last Name:CUMMINS
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 1:6007 TIMBER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-8134
Mailing Address - Country:US
Mailing Address - Phone:502-228-4700
Mailing Address - Fax:502-228-4797
Practice Address - Street 1:6007 TIMBER RIDGE DR
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-8134
Practice Address - Country:US
Practice Address - Phone:502-228-4700
Practice Address - Fax:502-228-4797
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY79621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice