Basic Information
| Provider Information | |||||||||
| NPI: | 1851380794 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KITCHENS | ||||||||
| FirstName: | DINAH | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 710 HART LN | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372430801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6156507000 | ||||||||
| FaxNumber: | 6152623139 | ||||||||
| Practice Location | |||||||||
| Address1: | 710 HART LN | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372430801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6156507000 | ||||||||
| FaxNumber: | 6152623139 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2005 | ||||||||
| LastUpdateDate: | 09/08/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 7611 | KY | N | Dental Providers | Dentist | 122300000X | DS8827 | TN | Y | Dental Providers | Dentist |
ID Information
| ID | Type | State | Issuer | Description | 60003324 | 05 | KY | MEDICAID |