Provider Demographics
NPI:1992520886
Name:PARSA, DENA
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:
Last Name:PARSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 UNIVERSITY CT APT B108
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1506
Mailing Address - Country:US
Mailing Address - Phone:310-497-7933
Mailing Address - Fax:
Practice Address - Street 1:3735 PALOMAR CENTRE DR STE 80
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1168
Practice Address - Country:US
Practice Address - Phone:859-223-0701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY024084183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist