| Kentucky River Dentistry, Psc | |
| 
					161 Richmond Rd Irvine KY 40336-7222  | |
| (606) 723-4112 | |
| (606) 723-5372 | 
| Full Name | Kentucky River Dentistry, Psc | 
|---|---|
| Speciality | Dentist - General Practice | 
| Location | 161 Richmond Rd, Irvine, Kentucky | 
| Authorized Official Name and Position | Jane Jordan (DENTIST) | 
| Authorized Official Contact | 6067234112 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Kentucky River Dentistry, Psc 161 Richmond Rd Irvine KY 40336-7222 Ph: (606) 723-4112  | Kentucky River Dentistry, Psc 161 Richmond Rd Irvine KY 40336-7222 Ph: (606) 723-4112  | 
| NPI Number | 1821131954 | 
|---|---|
| Provider Enumeration Date | 02/15/2007 | 
| Last Update Date | 09/23/2013 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1821131954 | NPI | - | NPPES | 
| 61900221 | Medicaid | KY | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6144 (Kentucky) | Primary | 
Irvine Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 934 Richmond Rd, Irvine, KY 40336 Phone: 606-723-1000 Fax: 606-723-1039  | |
Jimmie Lee Johnson Dmd Psc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 87 Wildwood Place, Irvine, KY 40336 Phone: 606-723-3213 Fax: 606-723-3213  |