Provider Demographics
NPI:1427667732
Name:CARDOSI, JOSEPH BLAIR (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:BLAIR
Last Name:CARDOSI
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 1:7901 MALL RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1496
Mailing Address - Country:US
Mailing Address - Phone:859-488-6844
Mailing Address - Fax:
Practice Address - Street 1:7901 MALL RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1496
Practice Address - Country:US
Practice Address - Phone:859-488-6844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY10480122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist