Provider Demographics
NPI:1942092689
Name:SPAW, JAMI TAYLOR (DMD)
Entity type:Individual
Prefix:
First Name:JAMI
Middle Name:TAYLOR
Last Name:SPAW
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 1:111 MAYES AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:40069-1415
Mailing Address - Country:US
Mailing Address - Phone:859-481-1960
Mailing Address - Fax:
Practice Address - Street 1:1485 OLD LEBANON RD
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-3356
Practice Address - Country:US
Practice Address - Phone:270-789-2155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY11340122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist