Facial Plastic Surgery & Dermatology PLLC
NPI 1881030088ActiveOrganization· Dermatology, MOHS-Micrographic Surgery· Lexington, KY
Dermatology, MOHS-Micrographic Surgery in Lexington, Kentucky, registered in NPPES in May 2013. The authorized official on file is Samuel Jack Pruden, MD, Owner.
Overview
| NPI | 1881030088 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 14, 2013 |
| Last updated in NPPES | Aug 27, 2013 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology, MOHS-Micrographic Surgery Primary | 207ND0101X | 34192 | KY |
| Dermatology | 207N00000X | 34192 | KY |
| Plastic Surgery | 208200000X | 34192 | KY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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