NPIMap

Organization Active NPI

Lisette Baechtold, D.M.D., M.S.

  • General Practice Dentistry
  • Richmond, KY
National Provider Identifier
1063508398
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6635 Issued in KY
Legal business name
LISETTE BAECHTOLD, D.M.D., M.S.
Practice address
2006 Merchant Dr
Richmond, KY 40475-8167
Phone
(859) 626-7977
Fax
(859) 626-5103
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

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

Authorized official

Name
Mrs. Leslie Lisette Baechtold, D.M.D., M.S.NPI 1295821551
Title
Dentist
Phone
(859) 626-7977

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 6635 KY
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 6635 KY Primary

Addresses

Primary practice location

2006 Merchant Dr
Richmond, KY 40475-8167

Mailing address

2006 Merchant Dr
Richmond, KY 40475-8167
Phone (859) 626-7977

Other identifiers 3

IdentifierTypeStateIssuer
60066354MedicaidKY
1603579OtherKYUNITED CONCORDIA
45004306MedicaidKY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248739200000",
    "number": "1063508398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 MERCHANT DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758167",
            "telephone_number": "859-626-7977",
            "fax_number": "859-626-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 MERCHANT DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758167",
            "telephone_number": "859-626-7977",
            "fax_number": "859-626-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISETTE BAECHTOLD, D.M.D., M.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2009-07-28",
        "status": "A",
        "authorized_official_last_name": "BAECHTOLD",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "LISETTE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "859-626-7977",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "D.M.D., M.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "KY",
            "license": "6635",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "6635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60066354",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1603579",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45004306",
            "state": "KY"
        }
    ],
    "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 Jul 28, 2009; 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.