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ADDISON YOUNG DMD PLLC

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Company Details

Name: ADDISON YOUNG DMD PLLC
Legal type: Kentucky Limited Liability Company
Status: Active
File Date: 31 Jan 2025 (4 months ago)
Organization Date: 31 Jan 2025 (4 months ago)
Managed By: Managers
Organization Number: 1426451
ZIP code: 40503
City: Lexington
Primary County: Fayette County
Principal Office: 3695 NICHOLASVILLE ROAD, SUITE 140, LEXINGTON, KY 40503
Place of Formation: KENTUCKY

Registered Agent

Name Role
DR. ADDISON YOUNG Registered Agent

Organizer

Name Role
ADDISON YOUNG Organizer

National Provider Identifier

NPI Number:
1508671058
Certification Date:
2025-02-11

Authorized Person:

Name:
CHRISTINE BARBER
Role:
PROVIDER ENROLLMENT TEAM LEAD
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Fax:
3154105531

Filings

Name File Date
Articles of Organization (LLC) 2025-01-31

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Sources: Kentucky Secretary of State