Jennifer Blincoe, DMD
Individual provider Active NPI Dentist · Fort Mitchell, KY
NPI 1477938124 · NPPES record last updated Jul 23, 2015
Key facts
- NPI
- 1477938124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 6417 (KY)
- Practice address
- 12 Orphanage Rd
Fort Mitchell, KY 41017-3072 - Phone
- (859) 331-1960
- Fax
- (859) 331-2257
- NPI assigned
- Jul 23, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6417 | KY | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6417 | KY | Yes |
Addresses
Primary practice location
12 Orphanage Rd
Fort Mitchell, KY 41017-3072
Mailing address
12 Orphanage Rd
Fort Mitchell, KY 41017-3072
Phone (859) 331-1960
Other providers in Fort Mitchell, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2015. 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.