Provider Demographics
NPI:1730457821
Name:LISA A. KOCHIS, PSC
Entity Type:Organization
Organization Name:LISA A. KOCHIS, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCHIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:859-971-1137
Mailing Address - Street 1:4071 TATES CREEK CENTRE DR STE 306
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-3065
Mailing Address - Country:US
Mailing Address - Phone:859-971-1137
Mailing Address - Fax:
Practice Address - Street 1:4071 TATES CREEK CENTRE DR STE 306
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-3065
Practice Address - Country:US
Practice Address - Phone:859-971-1137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY77821223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty