Provider Demographics
NPI:1750518619
Name:DAVID KUBEK, ANA KRISTINA (DDS)
Entity type:Individual
Prefix:MRS
First Name:ANA KRISTINA
Middle Name:
Last Name:DAVID KUBEK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 S 4TH ST
Mailing Address - Street 2:950C STARKS BUILDING
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2593
Mailing Address - Country:US
Mailing Address - Phone:502-587-6131
Mailing Address - Fax:502-584-8600
Practice Address - Street 1:455 S 4TH ST
Practice Address - Street 2:950C STARKS BUILDING
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-2593
Practice Address - Country:US
Practice Address - Phone:502-587-6131
Practice Address - Fax:502-584-8600
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8854122300000X
IN12011321A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist