NPIMap

Organization Active NPI

Kids Dentistree - Shepherdsville, PLLC

  • Pediatric Dentistry
  • Shepherdsville, KY
National Provider Identifier
1023496676
Registry record updated May 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
KIDS DENTISTREE - SHEPHERDSVILLE, PLLC
Practice address
1779 Highway 44 E
Suite 200
Shepherdsville, KY 40165-6132
Phone
(502) 281-4860
Fax
(502) 883-6995
NPI assigned
May 15, 2015
Last updated
May 15, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2015

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

Authorized official

Name
Stephen James
Title
Cfo
Phone
(502) 254-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X Primary

Addresses

Primary practice location

1779 Highway 44 E
Suite 200
Shepherdsville, KY 40165-6132

Mailing address

1779 Highway 44 E
Suite 200
Shepherdsville, KY 40165-6132
Phone (502) 281-4860

National Provider Directory

National Provider Directory

Locations

1779 Highway 44 E
Ste 200
Shepherdsville, KY 40165
Phone (502) 281-4860

Practitioners & affiliated clinicians

Practitioners 1

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": "1431648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431648000000",
    "number": "1023496676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1779 HIGHWAY 44 E",
            "address_2": "SUITE 200",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401656132",
            "telephone_number": "502-281-4860",
            "fax_number": "502-883-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1779 HIGHWAY 44 E",
            "address_2": "SUITE 200",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401656132",
            "telephone_number": "502-281-4860",
            "fax_number": "502-883-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS DENTISTREE - SHEPHERDSVILLE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-15",
        "last_updated": "2015-05-15",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-254-8500"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shepherdsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2015; 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.