Organization · Type 2 NPI

Identity Dental Studio, PLLC

Dental Clinic/Center · Lexington, KY

NPI number 1760975650 Active

Practice location

541 Darby Creek Road, Ste 190
Lexington, KY 40509

Fax (859) 287-2484

Specialties and licenses

Taxonomy	Code	License
Prosthodontics	1223P0700X	9038 (KY)
Dental Clinic/Center Primary	261QD0000X	None listed

Dental Clinic/Center: Definition to come...

Another provider at this address

Sleep Identity PLLCDental Clinic/Center Lexington, KY NPI 1710409370

Other dental clinic/center providers in Lexington

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NPI record

NPI: 1760975650
Entity type: Organization (Type 2)
Issued: Jun 14, 2018
Last updated: Jan 16, 2020
Status: Active
Subpart: Yes of Identity Dental Studio, PLLC

Other names

<unavail>
Ids Smile Lab · doing business as

Authorized official

Brandon M Stapleton, DMD, MSD
Dentist/owner
(859) 287-2484

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About NPI 1760975650

Identity Dental Studio, PLLC's National Provider Identifier is 1760975650, issued on Jun 14, 2018. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Lexington, KY. The record was last updated on Jan 16, 2020.