Provider Demographics
NPI:1225138852
Name:NASH, DAVID A (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:NASH
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 1:800 ROSE ST RM D104
Mailing Address - Street 2:UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0297
Mailing Address - Country:US
Mailing Address - Phone:859-323-6261
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE ST RM D104
Practice Address - Street 2:UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0297
Practice Address - Country:US
Practice Address - Phone:859-323-6261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3776122300000X, 1223G0001X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
No1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60003423Medicaid