Provider Demographics
NPI:1659477347
Name:TAKACS, PATRICIA E (DMD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:E
Last Name:TAKACS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:EILEEN
Other - Last Name:TAKACS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:3141 BEAUMONT CENTRE CIRCLE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513
Mailing Address - Country:US
Mailing Address - Phone:859-223-2120
Mailing Address - Fax:859-223-5276
Practice Address - Street 1:3141 BEAUMONT CENTRE CIRCLE
Practice Address - Street 2:SUITE 300
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513
Practice Address - Country:US
Practice Address - Phone:859-223-2120
Practice Address - Fax:859-223-5276
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY55951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY5595OtherLICENSE NUMBER
KY5595OtherLICENSE NUMBER