Provider Demographics
NPI:1962661439
Name:STAHR, JEFFREY DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:DAVID
Last Name:STAHR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 ALEXANDRIA DR
Mailing Address - Street 2:SUITE #3
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3151
Mailing Address - Country:US
Mailing Address - Phone:859-278-9391
Mailing Address - Fax:
Practice Address - Street 1:1710 ALEXANDRIA DR
Practice Address - Street 2:SUITE #3
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3151
Practice Address - Country:US
Practice Address - Phone:859-278-9391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY86131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice