NPIMap

Organization Active NPI

Highland Dental Dre PLLC

  • Dentist
  • Richmond, KY
National Provider Identifier
1043050628
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
HIGHLAND DENTAL DRE PLLC
Practice address
1001 Gibson Bay Dr Ste 202
Richmond, KY 40475-3544
Phone
(859) 625-0204
NPI assigned
May 30, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Authorized official

Name
Elizabeth Davis
Title
Director of Revenue
Phone
(859) 533-1109

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1001 Gibson Bay Dr Ste 202
Richmond, KY 40475-3544

Mailing address

1001 Gibson Bay Dr Ste 202
Richmond, KY 40475-3544
Phone (859) 625-0204

National Provider Directory

National Provider Directory

Locations

1001 Gibson Bay Dr
Ste 202
Richmond, KY 40475
Phone (859) 625-0204

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1043050628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 GIBSON BAY DR STE 202",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404753544",
            "telephone_number": "859-625-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 GIBSON BAY DR STE 202",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404753544",
            "telephone_number": "859-625-0204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND DENTAL DRE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE",
        "authorized_official_telephone_number": "859-533-1109"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.