Kentuckiana Oral & Maxillofacial Surgery Assoc Psc
Dental Clinic
2800 Cannons Ln, Ste 200, Louisville
Kentucky, 40205
502-454-4885 502-452-1926
Maps & DirectionsKentuckiana Oral & Maxillofacial Surgery Assoc Psc is a Dental Clinic in Louisville, Kentucky. It is located at 2800 Cannons Ln, Ste 200, Louisville, KY and its contact number is 502-454-4885. The authorized person for Kentuckiana Oral & Maxillofacial Surgery Assoc Psc is Dr. Nathan F Walters
who is President of the clinic and their contact number is 502-454-4885.
Kentuckiana Oral & Maxillofacial Surgery Assoc Psc Clinic have dental surgeons who are specialized in dentistry, diagnosis, prevention, and treatment of diseases and conditions of the oral cavity. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.
Complete Clinic Profile:
Kentuckiana Oral & Maxillofacial Surgery Assoc Psc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Kentuckiana Oral & Maxillofacial Surgery Assoc Psc |
| Specialization: | Dentistry |
| Clinic Address: | 2800 Cannons Ln, Ste 200, Louisville,
Kentucky, 40205 |
| Phone: | 502-454-4885 |
| Fax: | 502-452-1926 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Nathan F Walters |
| Position: | President |
| Contact Number: | 502-454-4885 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Kentuckiana Oral & Maxillofacial Surgery Assoc Psc clinic are as mentioned below.
| NPI Number: | 1396737011 |
| NPI Enumeration Date: | 18 Aug, 2005 |
| NPI Last Update On: | 06 Feb, 2018 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Kentuckiana Oral & Maxillofacial Surgery Assoc Psc are as mentioned below.
| Specialization | License Number | State | Status | |
| Oral and Maxillofacial Surgery | | Kentucky | Primary | |
| Dentist | | Kentucky | Secondary | |
| Oral & Maxillofacial Surgery | | Kentucky | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| DC1281 | Other | Kentucky | Railroad Medicare |
| 50004012 | Other | Kentucky | Passport Group |
| 7100224860 | Medicaid | Kentucky | |
| 7100231360 | Medicaid | Kentucky | |
| 7100232940 | Medicaid | Kentucky | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Kentuckiana Oral & Maxillofacial Surgery Assoc Psc
2800 Cannons Ln, Ste 200
Louisville, Kentucky |
| Zip: | 40205 |
| Phone Number: | 502-454-4885 |
| Fax Number: | 502-452-1926 |
Patients can reach Kentuckiana Oral & Maxillofacial Surgery Assoc Psc at
2800 Cannons Ln, Ste 200, Louisville, Kentucky or can
call to book an appointment on 502-454-4885.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.