Provider Demographics
NPI:1982797403
Name:SHIPLEY, WILLIAM SPENCER (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SPENCER
Last Name:SHIPLEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 OLD THIRD STREET ROAD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40272
Mailing Address - Country:US
Mailing Address - Phone:502-933-2228
Mailing Address - Fax:502-933-9786
Practice Address - Street 1:9900 OLD THIRD STREET ROAD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272
Practice Address - Country:US
Practice Address - Phone:502-933-2228
Practice Address - Fax:502-933-9786
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY66531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice