Provider Demographics
NPI:1710371372
Name:DELPONT, LAUREN (DMD, MSD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:DELPONT
Suffix:
Gender:F
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2931 EMINENT DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-6900
Mailing Address - Country:US
Mailing Address - Phone:606-233-9003
Mailing Address - Fax:
Practice Address - Street 1:105 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40507-2109
Practice Address - Country:US
Practice Address - Phone:859-935-9044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-22
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY96001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100398540Medicaid