Provider Demographics
NPI:1609396027
Name:HUNT, KATIE JO (DMD)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:JO
Last Name:HUNT
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 1:3616 BEECHWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40514-1743
Mailing Address - Country:US
Mailing Address - Phone:239-850-9637
Mailing Address - Fax:
Practice Address - Street 1:3695 NICHOLASVILLE RD STE 140
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-4493
Practice Address - Country:US
Practice Address - Phone:859-272-0130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1857648122300000X
KY10535122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist