NPIMap

Organization Active NPI

West End Family Dental Clinic LLC

  • General Practice Dentistry
  • Louisville, KY
National Provider Identifier
1053734541
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4776 Issued in KY
Legal business name
WEST END FAMILY DENTAL CLINIC LLC
Practice address
2418 W Market St
Louisville, KY 40212-1539
Phone
(502) 772-0704
Fax
(502) 772-9587
NPI assigned
Feb 4, 2014
Last updated
Feb 4, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Authorized official

Name
Dr. Phillip R. Williams, DMDNPI 1902969736
Title
Owner
Phone
(502) 772-0704

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4776 KY Primary

Addresses

Primary practice location

2418 W Market St
Louisville, KY 40212-1539

Mailing address

2418 W Market St
Louisville, KY 40212-1539
Phone (502) 772-0704

National Provider Directory

National Provider Directory

Locations

2418 W Market St
Louisville, KY 40212
Phone (502) 772-0704

Practitioners & affiliated clinicians

Practitioners 3

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": "1391472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391472000000",
    "number": "1053734541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 W MARKET ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402121539",
            "telephone_number": "502-772-0704",
            "fax_number": "502-772-9587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 W MARKET ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402121539",
            "telephone_number": "502-772-0704",
            "fax_number": "502-772-9587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST END FAMILY DENTAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-04",
        "last_updated": "2014-02-04",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-772-0704",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "4776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; 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.