Community Care of Kentucky, Inc
Organization Active NPI General Practice Dentistry · Madisonville, KY
NPI 1053799080 · NPPES record last updated May 7, 2018
Key facts
- NPI
- 1053799080
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Legal business name
- COMMUNITY CARE OF KENTUCKY, INC
- Practice address
- 1175 S Main St Ste 4
Madisonville, KY 42431-3337 - Phone
- (270) 383-5511
- Fax
- (270) 821-9602
- NPI assigned
- May 11, 2015
- Organization subpart
- No
Authorized official
- Name
- Jenell Stump
- Title
- Manager, Licensing & Credentialing
- Phone
- (629) 999-5006
Corporate family (same tax ID) 6
Practitioners 3
-
Whitney Deanne James, DMD
-
John Quinn Martino, D.D.S.
National Provider Directory
- Tax ID family
- Community Care of Kentucky Inc
Locations
1175 S Main St
Ste 4
Madisonville, KY 42431
Phone (270) 383-5511
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | Yes |
Addresses
Primary practice location
1175 S Main St Ste 4
Madisonville, KY 42431-3337
Mailing address
PO Box 2369
Anniston, AL 36202-2369
Phone (256) 741-7340
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100298140 | Medicaid | KY |
Other providers in Madisonville, KY
- Shannon Dale Coffman
- Alicia Marie Combs
- Ollie Combs
- Commonwealth Biomedical Research LLC
- Community Alternatives Kentucky, Inc.
- Community Care of Kentucky, Inc.
- Community United Methodist Hospital Inc
- Taylor Renee Compton
- Continuecare Hospital at Baptist Health Madisonville, Inc.
- Leslie Cook
All providers in Madisonville, KY · General Practice Dentistry in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.