Provider Demographics
NPI:1457974883
Name:PRABHU, AARTI SACHIN (DMD)
Entity Type:Individual
Prefix:
First Name:AARTI
Middle Name:SACHIN
Last Name:PRABHU
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 1:818 HIDDEN LOOP DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-9613
Mailing Address - Country:US
Mailing Address - Phone:606-425-3873
Mailing Address - Fax:
Practice Address - Street 1:NORTHERN KENTUCKY DENTAL CENTERS, 2446 ANDERSON ROAD
Practice Address - Street 2:
Practice Address - City:CRESCENT SPRINGS
Practice Address - State:KY
Practice Address - Zip Code:41017-4101
Practice Address - Country:US
Practice Address - Phone:859-331-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00000001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice