Provider Demographics
NPI:1942400445
Name:LAWSON, KRISTY PEPPER (DMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:PEPPER
Last Name:LAWSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:KRISTY
Other - Middle Name:A
Other - Last Name:PEPPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:800 ROSE ST
Mailing Address - Street 2:D104
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0297
Mailing Address - Country:US
Mailing Address - Phone:859-323-5831
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE STREET, ROOM D104
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0297
Practice Address - Country:US
Practice Address - Phone:859-323-5831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8277122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100022330Medicaid