Provider Demographics
NPI:1003709916
Name:HODGENS, LAKYNN ALEXIS (DMD)
Entity type:Individual
Prefix:
First Name:LAKYNN
Middle Name:ALEXIS
Last Name:HODGENS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3142 TAYLOR BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40215-2655
Mailing Address - Country:US
Mailing Address - Phone:859-481-4530
Mailing Address - Fax:
Practice Address - Street 1:3946 TAYLORSVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1450
Practice Address - Country:US
Practice Address - Phone:502-895-2218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY113731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice