TDS Ky Five

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

TDS KY FIVE

Practice address

156 Thierman LN
Louisville, KY 40207-5010

Phone

(502) 896-2822

NPI assigned

Jun 11, 2020

Organization subpart

No

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

Authorized official

Name

Adrienne Nicholson

Title

Regional Manager

Phone

(812) 569-2955

Specialties & licenses 1

Addresses

Other names 1

• Klein Dental Group Doing business as

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1013532415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 THIERMAN LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402075010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 THIERMAN LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402075010",
            "telephone_number": "502-896-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TDS KY FIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-11",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "ADRIENNE",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "812-569-2955"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Klein Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victoria Taylor, PHARMD
• TBD Acquisition LLC
• TBD Acquisition, LLC
• TBS Dental PLLC
• TD Ky One LLC
• TDS Ky Four, LLC
• TDS Ky Two
• Jessica Teachout, RN
• Rod-Janae D Teagle, RBT
• Barrett M Teague, APRN

• Dental Clinic/Center in Louisville, KY
• Providers in Louisville, KY by specialty
• Dental Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.