Provider Demographics
NPI:1427498864
Name:CAMENISCH, BRITTANY MICHELLE (DMD)
Entity type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:MICHELLE
Last Name:CAMENISCH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 HAMPTON WAY STE 10
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8885
Mailing Address - Country:US
Mailing Address - Phone:606-669-3503
Mailing Address - Fax:
Practice Address - Street 1:519 HAMPTON WAY STE 10
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8885
Practice Address - Country:US
Practice Address - Phone:606-669-3503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-30
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9332122300000X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist