NPIMap

Organization Active NPI

Ky Dental Professional, PSC

Doing business as Audubon Dental & Implant Center

  • Dentist
  • Lexington, KY
National Provider Identifier
1013160522
Registry record updated Jan 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6944 Issued in KY
Legal business name
KY DENTAL PROFESSIONAL, PSC
Doing business as
Audubon Dental & Implant Center
Practice address
1330 S Broadway
Lexington, KY 40504-2737
Phone
(859) 252-5220
Fax
(859) 252-0405
NPI assigned
Oct 28, 2008
Last updated
Jan 21, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Caron C Carbone
Title
Office Administrator
Phone
(859) 252-5220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6944 KY Primary

Addresses

Primary practice location

1330 S Broadway
Lexington, KY 40504-2737

Mailing address

1330 S Broadway
Lexington, KY 40504-2737
Phone (859) 252-5220

Other names 1

  • Audubon Dental & Implant Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kentucky Dental Professionals PSC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1330 S Broadway
Lexington, KY 40504
Phone (859) 252-5220

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232496000000",
    "number": "1013160522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042737",
            "telephone_number": "859-252-5220",
            "fax_number": "859-252-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042737",
            "telephone_number": "859-252-5220",
            "fax_number": "859-252-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KY DENTAL PROFESSIONAL, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2009-01-21",
        "status": "A",
        "authorized_official_last_name": "CARBONE",
        "authorized_official_first_name": "CARON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "859-252-5220",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "6944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Audubon Dental & Implant Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.