Provider Demographics
NPI:1144350794
Name:PARROTT, ERNEST WAYNE (DMD)
Entity type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:WAYNE
Last Name:PARROTT
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 1:307 NORTH BROAD STREET
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741
Mailing Address - Country:US
Mailing Address - Phone:606-878-9755
Mailing Address - Fax:
Practice Address - Street 1:307 NORTH BROAD STREET
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741
Practice Address - Country:US
Practice Address - Phone:606-878-9755
Practice Address - Fax:606-862-9513
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4993KY1223G0001X
KY4993122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60049939Medicaid