Provider Demographics
NPI:1831626886
Name:PRICE, BRIANA LYNN (DMD)
Entity type:Individual
Prefix:DR
First Name:BRIANA
Middle Name:LYNN
Last Name:PRICE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:BRIANA
Other - Middle Name:LYNN
Other - Last Name:TACKETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:460 MADISON POINT DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-4823
Mailing Address - Country:US
Mailing Address - Phone:606-367-5807
Mailing Address - Fax:
Practice Address - Street 1:1072 BARNES MILL RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8729
Practice Address - Country:US
Practice Address - Phone:859-353-6309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty