NPIMap

Organization Active NPI

Dental Care of Kentucky - Dr O.Craig Shanteau, DDS, PSC

Doing business as Nichols Park Dental Care

  • Dentist
  • Lexington, KY
National Provider Identifier
1063576031
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DENTAL CARE OF KENTUCKY - DR O.CRAIG SHANTEAU, DDS, PSC
Doing business as
Nichols Park Dental Care
Practice address
4097 Nichols Park Dr
Suite 108
Lexington, KY 40503-4428
Phone
(859) 971-9298
Fax
(859) 971-9603
NPI assigned
Dec 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Amy M Kroeger
Title
Ins Cood
Phone
(217) 540-5100

Specialties & licenses 1

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

Addresses

Primary practice location

4097 Nichols Park Dr
Suite 108
Lexington, KY 40503-4428

Mailing address

4097 Nichols Park Dr
Suite 108
Lexington, KY 40503-4428
Phone (859) 971-9298

Other names 1

  • Nichols Park Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Care of Kentucky - Dr O Craig Shanteau DDS PSC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4097 Nichols Park Dr
Ste 108
Lexington, KY 40503
Phone (859) 245-2273

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063576031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4097 NICHOLS PARK DR",
            "address_2": "SUITE 108",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405034428",
            "telephone_number": "859-971-9298",
            "fax_number": "859-971-9603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4097 NICHOLS PARK DR",
            "address_2": "SUITE 108",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405034428",
            "telephone_number": "859-971-9298",
            "fax_number": "859-971-9603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL CARE OF KENTUCKY - DR O.CRAIG SHANTEAU, DDS, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KROEGER",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "INS COOD",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nichols Park Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.