DIXIE DENTAL CENTER (NPI# 1679986160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679986160 |
| Entity Type | Organization |
| Organization Name | DIXIE DENTAL CENTER |
| Practice Address |
1480 Dixie Hwy Louisville KY 40210-1768 |
| Practice Telephone | 5027787414 |
| Mailing Telephone | 5027787414 |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2014-06-03 |
| Authorized Official Name | DR. ROD FULTZ (DENTIST) |
| Authorized Official Telephone | 5027787414 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 61942355 | 05 |
| Street Address |
1480 DIXIE HWY |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40210-1768 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649260464 | David Neal Waugh | Dentist | 1480 Dixie Hwy, Louisville, KY 40210-1768 | 2005-10-24 |
| 1194900100 | Mahyar Mofidi | Dentist | 1480 Dixie Hwy, Louisville, KY 40210 | 2008-01-09 |
| 1962552042 | Dixie Dental Center Psc | Clinic/Center | 1480 Dixie Hwy, Louisville, KY 40210 | 2007-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568919322 | Drjbcdc | Chiropractor | 1714 Dixie Hwy, Louisville, KY 40210 | 2016-09-08 |
| 1528494770 | Valerie Gholson Day | Marriage & Family Therapist | 1620 Anderson St, Louisville, KY 40210-1032 | 2013-09-19 |
| 1851821532 | Heart 2 Heart Veterans Care | Nurse's Aide | 2518 Osage Ave, Louisville, KY 40210-1116 | 2017-06-15 |
| 1588127310 | Klf Company LLC | Community/Behavioral Health | 1833 Date St, Louisville, KY 40210-1245 | 2019-04-09 |
| 1407305998 | Prorehab Louisville | Clinic/Center | 902 S 15th St, Louisville, KY 40210-1319 | 2016-09-26 |
| 1568070480 | Stimar Healthcare LLC | Nurse Practitioner | 2111 W Oak St, Louisville, KY 40210-1419 | 2020-07-16 |
| 1982240115 | Geri Ann Thomas | Nurse Practitioner | 2228 Hale Ave, Louisville, KY 40210-1436 | 2019-11-22 |
| 1649747882 | Tanika L. Owens | Kinesiotherapist | 1022 Dumesnil St., Louisville, KY 40210-1517 | 2018-10-25 |
| 1730559428 | Tnt Fitness Training, LLC | Home Health | 1022 Dumesnil St, Louisville, KY 40210-1517 | 2015-10-07 |
| 1831677319 | Teresa Lynn Marshall-bland | Counselor | 1218 W Oak St, Louisville, KY 40210-1533 | 2018-08-06 |
| Find all providers in zip 40210 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235781485 | Rylie Mike-mayer | Dentist | 302 Axis Dr Apt 401, Louisville, KY 40206-0139 | 2019-07-09 |
| 1922580653 | Advanced Dental Center, Inc. | Dentist | 1901 Rudy Ln Ste 4, Louisville, KY 40207-1384 | 2018-08-29 |
| 1043701451 | Diana H Tran | Dentist | 501 S Preston St Rm 148, Louisville, KY 40202-1701 | 2018-05-21 |
| 1992295653 | Tyler Benton Blount | Dentist | 8013 New La Grange Rd Ste 6, Louisville, KY 40222-4700 | 2018-05-17 |
| 1407346901 | Louisville Dental Associates LLC | Dentist | 16701 E Main St, Louisville, MS 39339-2751 | 2018-05-10 |
| 1194238816 | Dental Services of Kentucky, Psc | Dentist | 2011 Grinstead Dr Unit 102, Louisville, KY 40204-1296 | 2017-11-16 |
| 1366963373 | Caleb William Reece | Dentist | 2201 Biljana Dr Apt 1, Louisville, KY 40206-2175 | 2017-06-29 |
| 1205366846 | Triple Crown Dentistry | Dentist | 904 Lily Creek Road, Suite 101, Louisville, KY 40243 | 2017-06-15 |
| 1740733559 | Jonathan Mitchell, Dmd, Psc | Dentist | 1716 Gardiner Ln, Louisville, KY 40205-2738 | 2016-07-27 |
| 1215389168 | Charles Kendrick Bunch | Dentist | 1030 Mulberry St, Louisville, KY 40217-1253 | 2016-07-04 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40210 |
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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.