Individual provider Active NPI

Shalesh Kumar

  • General Practice Dentistry
  • Louisville, KY
National Provider Identifier
1053507418
Registry record updated May 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8687 Issued in KY
Practice address
3438 Taylor Blvd
Louisville, KY 40215-2648
Phone
(502) 366-4442
NPI assigned
Sep 19, 2007
Last updated
May 26, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12011068A IN
General Practice Dentistry 1223G0001X 8687 KY Primary

Addresses

Primary practice location

3438 Taylor Blvd
Louisville, KY 40215-2648

Mailing address

3438 Taylor Blvd
Louisville, KY 40215-2648
Phone (502) 366-4442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160516002258 IN Order and Referring Only - DentistPractitioner - Dentist 7810286796

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8687KYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274832000000",
    "number": "1053507418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3438 TAYLOR BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402152648",
            "telephone_number": "502-366-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3438 TAYLOR BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402152648",
            "telephone_number": "502-366-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "SHALESH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-19",
        "last_updated": "2010-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011068A",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "8687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.