KIDS DENTISTREE OF KY LLC (NPI# 1588204655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588204655 |
| Entity Type | Organization |
| Organization Name | KIDS DENTISTREE OF KY LLC |
| Practice Address |
8727 Old Bardstown Rd Louisville KY 40291-4490 |
| Mailing Address |
Po Box 437169 Louisville KY 40253-7169 |
| Practice Telephone | 5022548500 |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2020-01-07 |
| Authorized Official Name | STEPHAN JAMES (CFO) |
| Authorized Official Telephone | 5022548500 |
| Is Organization Subpart | Y |
| Parent Organization Name | KIDS DENTISTREE OF KY LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Kids Dentistree - Glenmary | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497386049 | Kids Dentistree of Ky LLC | Dentist | 1508 Oxford Dr, Georgetown, KY 40324-9266 | 2020-02-03 |
| Street Address |
8727 OLD BARDSTOWN RD |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40291-4490 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881117166 | The Degondaba School, Inc. | Day Training, Developmentally Disabled Services | 5110 Stony Brook Drive, Louisville, KY 40291 | 2017-07-19 |
| 1497108278 | Andrea Herndon | Physician Assistant | 10710 Marceitta Ct, Louisville, KY 40291 | 2016-07-18 |
| 1033536602 | Jennifer Rose Fowler | Social Worker | 10300 Brookridge Villeage Blvd., Suite 104, Louisville, KY 40291 | 2014-03-21 |
| 1740602069 | Brittney Tatum | Licensed Practical Nurse | 9500 Glen Trace Ln, Louisville, KY 40291 | 2014-01-07 |
| 1326392895 | Lisa J Fetter | Nurse Practitioner | 6413 Bardstown Rd, Louisville, KY 40291 | 2012-11-05 |
| 1275829137 | Carolyn Estep Book | Counselor | 9612 Farmstead Lane, Louisville, KY 40291 | 2011-06-20 |
| 1023309028 | Julie Klein Hawkins | Pharmacist | 8014 Bardstown Rd., Louisville, KY 40291 | 2011-04-25 |
| 1295872653 | Loving Care Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9508 Fairmount Rd, Louisville, KY 40291 | 2007-02-01 |
| 1962548198 | Morgan Howard | Chiropractor | 5501 Bardstown Rd, Louisville, KY 40291 | 2007-01-29 |
| 1407992258 | Deanna H Smith | Social Worker | 9409 Cedar Look Drive, Louisville, KY 40291 | 2007-01-29 |
| Find all providers in zip 40291 | ||||
| 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 |
| 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 |
| 1801036637 | Coastal Kids Dental | Dentist | 1931 Strathmoor Blvd, Louisville, KY 40205-2525 | 2009-03-06 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40291 |
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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.