Active NPI
Ciara Sandefur, DMD
- General Practice Dentistry
- Louisville, KY
National Provider Identifier
1073305678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11339
- Practice address
- 3015 Wilson Ave
Louisville, KY 40211-1969 - Phone
- (502) 774-4401
- NPI assigned
- May 20, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11339 | KY | Primary |
Addresses
Primary practice location
3015 Wilson Ave
Louisville, KY 40211-1969
Mailing address
5290 Deatsville Rd
Coxs Creek, KY 40013-8828
Phone (502) 492-2343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11339 | KY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747699200000",
"number": "1073305678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5290 DEATSVILLE RD",
"city": "COXS CREEK",
"state": "KY",
"postal_code": "400138828",
"telephone_number": "502-492-2343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3015 WILSON AVE",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402111969",
"telephone_number": "502-774-4401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDEFUR",
"first_name": "CIARA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-20",
"last_updated": "2025-05-20",
"certification_date": "2025-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "11339",
"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 May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.