ERENA & PETERSON, PLLC (NPI# 1285942649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285942649 |
| Entity Type | Organization |
| Organization Name | ERENA & PETERSON, PLLC |
| Practice Address |
620 Perimeter Dr Suite 100 Lexington KY 40517-4125 |
| Practice Telephone | 8592684423 |
| Practice Fax Number | 8592680010 |
| Mailing Telephone | 8592684423 |
| Mailing Fax Number | 8592680010 |
| Enumeration Date | 2010-09-20 |
| Last Update Date | 2011-07-06 |
| Authorized Official Name | MS. SHARON L. HINTON (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 8592684423 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204E00000X | Oral & Maxillofacial Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | MEDICAID DENTAL | 7100150110 | 01 |
| KY | MEDICAID MEDICAL | 7100158900 | 01 |
| MEDICARE PTAN | P100036989 | 01 |
| Street Address |
620 PERIMETER DR SUITE 100 |
| City | LEXINGTON |
| State | KY |
| Zip Code | 40517-4125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053317214 | Gregory R Erena | Dentist | 620 Perimeter Dr, Ste 100, Lexington, KY 40517-4125 | 2005-06-22 |
| 1588941298 | Nancy Katherine Von Lackum | Dentist | 620 Perimeter Dr, Suite 103, Lexington, KY 40517-4125 | 2011-11-08 |
| 1134418353 | John M Falace, Dmd | Dentist | 620 Perimeter Dr, Ste 200, Lexington, KY 40517-4125 | 2011-03-29 |
| 1124327200 | Perimeter Periodontics Pllc | Dentist | 620 Perimeter Dr, Ste 103, Lexington, KY 40517-4125 | 2011-03-15 |
| 1669633079 | John Michael Falace | Dentist | 620 Perimeter Dr, Ste 200, Lexington, KY 40517-4125 | 2008-06-18 |
| 1417152166 | William G Fain | Dentist | 620 Perimeter Dr, Suite 206, Lexington, KY 40517-4125 | 2007-06-20 |
| 1861697518 | Jill M Miller | Dentist | 620 Perimeter Dr, Suite 206, Lexington, KY 40517-4125 | 2007-06-20 |
| 1063586261 | Gregory Alan Carman | Dentist | 620 Perimeter Dr, Suite 203, Lexington, KY 40517-4125 | 2006-11-20 |
| 1497830525 | William Daugherty | Dentist | 620 Perimeter Dr, Suite 207, Lexington, KY 40517-4125 | 2006-10-26 |
| 1225113343 | Edward Tipton | Dentist | 620 Perimeter Dr, Lexington, KY 40517-4125 | 2006-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548861842 | Odell Levi Dixon | Peer Specialist | 105 S Main Cross St, Louisa, KY 40517 | 2020-11-03 |
| 1538638515 | Lionheart Trauma Support Services, LLC | Social Worker | 168 E Reynolds Rd., Suite 210, Lexington, KY 40517 | 2018-11-19 |
| 1467964486 | Leila M Goodpaster | Counselor | 3205 Elk Lake Ct., Lexington, KY 40517 | 2017-10-31 |
| 1588108609 | Body Structure Clinic | Dietitian, Registered | 2600 Gribbin Dr., Lexington, KY 40517 | 2016-12-08 |
| 1932538766 | Lydia Akin | Social Worker | 3150 Custer Dr., Suite 103, Lexington, KY 40517 | 2013-11-02 |
| 1083986335 | Family Counseling Service | Social Worker | 1393 Trent Blvd., Lexington, KY 40517 | 2012-02-02 |
| 1356624233 | Michael Glindmeyer | Physical Therapist | 2600 Gribbin Drive, Lexington, KY 40517 | 2011-09-27 |
| 1740574052 | Benjamin Marshall | Psychiatry & Neurology | 228 E. Reynolds Rd, Ste B2, Lexington, KY 40517 | 2011-06-03 |
| 1982913745 | Cynae Rashel Carter | Social Worker | 343 Waller Avenue, Suite 201, Lexington, KY 40517 | 2010-09-28 |
| 1548401185 | Jason Eugene Thomas | Counselor | 1393 Trent Boulevard, Building 2, Suite 2101, Lexington, KY 40517 | 2009-03-11 |
| Find all providers in zip 40517 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942705728 | Karah Lee Ellen Brown | Dentist | 800 Rose Street, Room D-508, Lexington, KY 40536 | 2018-03-26 |
| 1326400789 | Corey Alan Taylor | Dentist | 800 Rose St # D-538, Lexington, KY 40536-7001 | 2016-03-24 |
| 1689060808 | Brandyn Herman | Dentist | Uk Dentistry At Turfland, 2195 Harrodsburg Rd, Ste 175, Lexington, KY 40536 | 2015-04-14 |
| 1619243268 | William J Curtis | Dentist | 800 Rose St Rm D508, University of Kentucky College of Dentistry, Lexington, KY 40536-0297 | 2012-03-28 |
| 1053541219 | Andrew William Ray | Dentist | 2421 Gooseberry Cir, Lexington, KY 40509-8567 | 2009-07-22 |
| 1952557852 | Ali Ebrahim Mohammad | Dentist | 800 Rose St Rm D-508, Lexington, KY 40536 | 2008-08-11 |
| 1346403235 | David Peter Schmidt | Dentist | Division of Oral and Maxillofacial Surgery, College of Dentistry, Lexington, KY 40536-0001 | 2008-07-09 |
| 1205955168 | Associates In Oral & Maxillofacial Surgery, Pa | Dentist | 307 Columbia Ave, Lexington, SC 29072-2613 | 2007-03-29 |
| 1336157098 | Nick Samuel Morrow | Dentist | 216 Fountain Ct Ste 110, Lexington, KY 40509-1888 | 2006-08-04 |
| 1437177722 | William Scott Jenkins | Dentist | 216 Fountain Ct, Suite 110, Lexington, KY 40509-1888 | 2006-07-17 |
| Find all providers in LEXINGTON | ||||
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| 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.