Provider Demographics
NPI:1932550498
Name:CHILDERS, VICTORIA PAIGE (DMD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:PAIGE
Last Name:CHILDERS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:PAIGE
Other - Last Name:CHANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:740 S LIMESTONE A219
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-9314
Mailing Address - Country:US
Mailing Address - Phone:859-323-5294
Mailing Address - Fax:
Practice Address - Street 1:110 DIAGNOSTIC DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-6557
Practice Address - Country:US
Practice Address - Phone:502-223-7186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY98911223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry