PERIODONTAL CARE & IMPLANT CENTER (NPI# 1114944816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114944816 |
| Entity Type | Organization |
| Organization Name | PERIODONTAL CARE & IMPLANT CENTER |
| Practice Address |
3409 Stony Spring Cir Louisville KY 40220-5433 |
| Practice Telephone | 5024996171 |
| Practice Fax Number | 5024999980 |
| Mailing Telephone | 5024996171 |
| Mailing Fax Number | 5024999980 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. MELISSA KAYE CORBIT (OFFICE MANAGER) |
| Authorized Official Telephone | 5024996171 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
6418 | KY | Dental Providers |
| Street Address |
3409 STONY SPRING CIR |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40220-5433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720009418 | Jill Hayes Bassett | Dentist | 3409 Stony Spring Cir, Louisville, KY 40220-5433 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811502560 | Louis James Walker IIi | Physical Therapist | 8904 Elks Bluff Drive, Unit 02206, Apt 206, Louisville, KY 40220 | 2020-09-10 |
| 1396207148 | Kristan Shay Swindler | Specialist/Technologist, Other | 3008 Furman Blvd., Louisville, KY 40220 | 2019-04-02 |
| 1033686191 | Reine Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 3405 Breckenridge Lane, Louisville, KY 40220 | 2018-10-26 |
| 1053828145 | Angelique Marie Leist | Registered Nurse | 3103 Breckenridge Ln Ste 1, Louisville, KY 40220 | 2018-01-10 |
| 1811413925 | Virginia Zimlich | Physical Therapist | 2807 Alice Ave, Louisville, KY 40220 | 2017-08-21 |
| 1255860649 | Susan Marie Elder | Registered Nurse | 2816 Esther Blvd, Louisville, KY 40220 | 2017-06-08 |
| 1215300611 | Katie Kipfer | Day Training/Habilitation Specialist | 3902 Graf Drive, Louisville, KY 40220 | 2015-11-06 |
| 1639547987 | Meghan Hillerich | Home Health | 13 Canterbury Drive, Louisville, KY 40220 | 2015-09-03 |
| 1376921098 | Dental Services of Kentucky, Psc | Dentist | 3946 Taylorsville Rd., Louisville, KY 40220 | 2015-05-14 |
| 1093103574 | Joann Bartolone Murphy | Developmental Therapist | 3717 Taylorsville Rd., Louisville, KY 40220 | 2015-01-06 |
| Find all providers in zip 40220 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447789029 | John Andrew Houston | Dentist | 5141 Dixie Hwy Ste 102, Louisville, KY 40216-1765 | 2017-06-07 |
| 1710191317 | Carl N. Bauman | Dentist | 10228 Shelbyville Rd, Louisville, KY 40223-2978 | 2007-05-10 |
| 1164563664 | Ziad Dib | Dentist | 501 S Preston, Room 236, Louisville, KY 40292-0001 | 2007-02-09 |
| 1295873479 | Ricardo L Vidal Gonzalez | Dentist | 1313 Lyndon Ln Ste 214, Louisville, KY 40222 | 2007-02-01 |
| 1558323873 | Patricia W Tucker | Dentist | 902 Dupont Rd, Louisville, KY 40207-4602 | 2006-04-03 |
| 1174166821 | Muhammad Saleh | Dentist | 501 S Preston St, Louisville, KY 40202-1701 | 2019-10-25 |
| 1003390352 | Niyati Kapadia | Dentist | 401 E Chestnut St Unit 550, Louisville, KY 40202-5705 | 2018-09-22 |
| 1962850503 | Hima Bindu Pallagorla | Dentist | 501 S Preston St, Room 312, Louisville, KY 40202-1701 | 2016-05-24 |
| 1588099683 | Diksha Katwal | Dentist | 501 S Preston St, Louisville, KY 40202-1701 | 2013-09-08 |
| 1912028291 | Elisa Pape Millett | Dentist | 4906 Bardstown Rd, Suite 104, Louisville, KY 40291-1759 | 2007-04-03 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40220 |
Please comment or provide details below to improve the information on PERIODONTAL CARE & IMPLANT CENTER.
| 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.