Provider Demographics
NPI:1760606891
Name:SIEVERS, LOU P (DMD)
Entity Type:Individual
Prefix:DR
First Name:LOU
Middle Name:P
Last Name:SIEVERS
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 1:1081 DOVE RUN RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-3584
Mailing Address - Country:US
Mailing Address - Phone:859-269-7135
Mailing Address - Fax:
Practice Address - Street 1:1081 DOVE RUN RD
Practice Address - Street 2:SUITE 106
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-3584
Practice Address - Country:US
Practice Address - Phone:859-269-7135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6560122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist