Provider Demographics
NPI:1578723169
Name:OLIVER, HANNAH RAE (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:RAE
Last Name:OLIVER
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:DR
Other - First Name:HANNAH
Other - Middle Name:RAE
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD, MS
Mailing Address - Street 1:6613 EVERTON DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-3368
Mailing Address - Country:US
Mailing Address - Phone:502-759-2571
Mailing Address - Fax:
Practice Address - Street 1:6613 EVERTON DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-3368
Practice Address - Country:US
Practice Address - Phone:502-759-2571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY86501223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics