Provider Demographics
NPI:1295806818
Name:DUNKER, DEBORAH BORDEN (DMD ORTHODONTIST MS)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:BORDEN
Last Name:DUNKER
Suffix:
Gender:F
Credentials:DMD ORTHODONTIST MS
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:RENEE
Other - Last Name:BORDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD ORTHODONTIST MS
Mailing Address - Street 1:822 PARIS RD
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42066-2743
Mailing Address - Country:US
Mailing Address - Phone:270-247-0751
Mailing Address - Fax:270-247-0757
Practice Address - Street 1:822 PARIS RD
Practice Address - Street 2:
Practice Address - City:MAYFIELD
Practice Address - State:KY
Practice Address - Zip Code:42066-2743
Practice Address - Country:US
Practice Address - Phone:270-247-0751
Practice Address - Fax:270-247-0757
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY52351223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
5235Medicare UPIN