KIDS DENTISTREE - WESTPORT VILLAGE (NPI# 1063808608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063808608 |
| Entity Type | Organization |
| Organization Name | KIDS DENTISTREE - WESTPORT VILLAGE |
| Practice Address |
1106 Lyndon Ln Louisville KY 40222-4318 |
| Practice Telephone | 5022546075 |
| Practice Fax Number | 5023339750 |
| Mailing Telephone | 5022546075 |
| Mailing Fax Number | 5023339750 |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2015-04-10 |
| Authorized Official Name | STEVE JAMES (CFO) |
| Authorized Official Telephone | 5022548504 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
1106 LYNDON LN |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40222-4318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245679034 | Roger Preston Dotsey | Dentist | 1106 Lyndon Ln, Louisville, KY 40222-4318 | 2013-06-14 |
| 1760878300 | Braces Braces Braces - Westport | Dentist | 1106 Lyndon Ln, Suite B, Louisville, KY 40222-4318 | 2015-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881507 | Lucas Counseling and Consulting | Counselor | 8134 New Lagrange Road Suite 100, Louisville, KY 40222 | 2020-11-06 |
| 1700424157 | Hope4hearts Counseling LLC | Community/Behavioral Health | 7321 New Lagrange Road, Louisville, KY 40222 | 2019-12-17 |
| 1982162509 | Sydney Sleadd | Massage Therapist | 7505 New Lagrange Rd, Ste 101, Louisville, KY 40222 | 2019-03-04 |
| 1205390127 | Rebecca A Street | Marriage & Family Therapist | 8134 New La Grange Rd Ste 227, Louisville, KY 40222 | 2019-01-24 |
| 1689176166 | Andrew Pennington | Social Worker | 1015 Dorsey Ln., Louisville, KY 40222 | 2018-03-01 |
| 1578085957 | Megan Lusco | Case Manager/Care Coordinator | 312 Whittington Parkway, Suite 020, Louisville, KY 40222 | 2017-07-07 |
| 1083149868 | Kate Oliver Ray | Optometrist | 2420 Lime Kiln Ln Ste H, Louisville, KY 40222 | 2017-04-28 |
| 1578094736 | Jacqueline Ward | Speech-Language Pathologist | 910 Fenley Avenue, Louisville, KY 40222 | 2017-03-21 |
| 1295195907 | Carol Massey | Psychologist | 7400 Newlagrange Roed, 308, Louisville, KY 40222 | 2016-02-24 |
| 1588047260 | Melissa Cosby | Case Manager/Care Coordinator | 312 Whittington Parkway Suite 020, Louisville, KY 40222 | 2015-06-30 |
| Find all providers in zip 40222 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518599802 | Derby City Pediatric Dentistry, Pllc | Dentist | 2120 High Wickham Pl Ste 103, Louisville, KY 40245-5903 | 2020-02-05 |
| 1588204655 | Kids Dentistree of Ky LLC | Dentist | 8727 Old Bardstown Rd, Louisville, KY 40291-4490 | 2020-01-07 |
| 1780141580 | Morgan Marie Nowery | Dentist | 134 Gillette Ave, Louisville, KY 40214-1914 | 2019-02-27 |
| 1578030995 | Huda Hussain Alkuhl | Dentist | 501 S Preston St Fl 3, Louisville, KY 40202-1701 | 2018-10-24 |
| 1083144265 | Kelly Wessel | Dentist | 4413 Santa Paula Ln, Louisville, KY 40219-3820 | 2017-06-19 |
| 1548620560 | Myron F Shuster Dmd Psc | Dentist | 3101 Breckenridge Ln Ste 4b, Louisville, KY 40220-2797 | 2016-03-03 |
| 1396138616 | Uday K Bahunutula | Dentist | 2002 Fandango Ct, Louisville, KY 40245-5441 | 2015-03-11 |
| 1255757852 | Dupont Pediatric Dentistry | Dentist | 1001 Dupont Square North, Louisville, KY 40207 | 2014-03-07 |
| 1659610269 | Kids Dentistry- Dixie Highway Pllc | Dentist | 9707 Dixie Hwy, B, Louisville, KY 40272-3939 | 2013-02-04 |
| 1821317132 | Jenna R Schulten | Dentist | 1001 N Dupont Sq, Louisville, KY 40207-4612 | 2010-05-26 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40222 |
Please comment or provide details below to improve the information on KIDS DENTISTREE - WESTPORT VILLAGE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.