Provider Demographics
NPI:1780930701
Name:THOMPSON, KRISTEN FROMMEYER (DMD)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:FROMMEYER
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:FROMMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1820 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:FT WRIGHT
Mailing Address - State:KY
Mailing Address - Zip Code:41011-2606
Mailing Address - Country:US
Mailing Address - Phone:859-431-3254
Mailing Address - Fax:
Practice Address - Street 1:1820 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:FT WRIGHT
Practice Address - State:KY
Practice Address - Zip Code:41011-2606
Practice Address - Country:US
Practice Address - Phone:859-431-3254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-27
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9424122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist