Lake Cumberland Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

9333 Issued in KY

Legal business name

LAKE CUMBERLAND PEDIATRIC DENTISTRY

Practice address

100 Hardin LN Ste a
Somerset, KY 42503-3812

Phone

(859) 421-7838

NPI assigned

Jul 16, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Angela Davidson Gabbard, DMDNPI 1962847285

Title

Pediatric Dentist

Phone

(859) 421-7838

Specialties & licenses 1

Addresses

Practitioners 1

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

• Angela Davidson Gabbard, DMD

  • Pediatric Dentistry
  • Somerset, KY
  • NPI 1962847285
  NPD Authorized official

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1073099792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HARDIN LN STE A",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033812",
            "telephone_number": "606-425-5504",
            "fax_number": "606-425-5804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HARDIN LN STE A",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033812",
            "telephone_number": "859-421-7838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CUMBERLAND PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-16",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "GABBARD",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "DAVIDSON",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "859-421-7838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "9333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Cumberland District Health Dept
• Lake Cumberland District Heatlh Dept
• Lake Cumberland Gastroenterology and Internal Medicine Assoc. Inc.
• Lake Cumberland Neurosurgical Clinic
• Lake Cumberland Neurosurgical Clinic PSC
• Lake Cumberland Pediatric Therapy, LLC
• Lake Cumberland Pediatric Therapy, LLC
• Lake Cumberland Physician Practices
• Lake Cumberland Physician Practices LLC
• Lake Cumberland Physician Practices LLC

• Pediatric Dentistry in Somerset, KY
• Providers in Somerset, KY by specialty
• Pediatric Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.