Jackie L Banahan in Lexington - Pediatric Dentistry
Jackie L Banahan - NPI 1093866154
Jackie L Banahan is a Pediatric Dentistry in Lexington, Kentucky. Jackie L Banahan practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Jackie L Banahan is 1093866154. The last update date is 2007-07-08.
Jackie L Banahan's current location address is 3141 Beaumont Centre Cir, Lexington, Kentucky. You can contact this provider via phone number 8592234888 and fax number 8592964688. The mailing address for Jackie L Banahan is 3141 Beaumont Centre Cir, Lexington, Kentucky. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jackie L Banahan |
|---|---|
| Address | 3141 Beaumont Centre Cir, Lexington, Kentucky |
| Phone Number | 8592234888 |
| Fax Number | 8592964688 |
| Sole Proprietor | Y |
| Credentials | D.M.D. |
NPI Number Detail
| NPI Number | 1093866154 |
|---|---|
| Provider Enumeration Date | 2007-01-16 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 3141 Beaumont Centre Cir |
|---|---|
| City | Lexington |
| State | Kentucky (KY) |
| Post Code | 405131934 |
| Phone Number | 8592234888 |
| Fax Number | 8592964688 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 4977 |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 60049772 | KY | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Jackie L Banahan by the Centers for Medicare & Medicaid Services?
The Jackie L Banahan has been assigned the NPI (National Provider Identifier) 1093866154. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Jackie L Banahan is physically located?
The Jackie L Banahan is situated at the following address: 3141 Beaumont Centre Cir, Lexington, KY 405131934.
What is Jackie L Banahan's specialized field of practice, and what is the corresponding taxonomy classification code?
The Jackie L Banahan's area of specialization is Pediatric Dentistry, and the corresponding taxonomy code that categorizes this field of practice is 1223P0221X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1093866154 to Jackie L Banahan?
The Centers for Medicare & Medicaid Services originally issued the 1093866154 to Jackie L Banahan on 2007-01-16.
As of what date were the Jackie L Banahan's details last updated?
The information pertaining to the Jackie L Banahan, including its address, specialty, and other details, was most recently updated on 2007-07-08.
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