Provider Demographics
NPI:1871505164
Name:DUNKUM, JOSEPH OWEN (DMD)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:OWEN
Last Name:DUNKUM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 S HIGHWAY 27
Mailing Address - Street 2:STE 4
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-2774
Mailing Address - Country:US
Mailing Address - Phone:606-679-3277
Mailing Address - Fax:606-636-6623
Practice Address - Street 1:370 S HIGHWAY 27
Practice Address - Street 2:STE 4
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-2774
Practice Address - Country:US
Practice Address - Phone:606-679-3277
Practice Address - Fax:606-636-6623
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60036761Medicaid
KY869718OtherBLUE CROSS BLUE SHIELD