Pavon Family Dentistry P.S.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6711 Issued in KY

Legal business name

PAVON FAMILY DENTISTRY P.S.C.

Doing business as

Portland Dental Center and Broadway Dental

Practice address

465 N 26TH St
Louisville, KY 40212-1449

Phone

(502) 778-7767

Fax

(502) 778-7677

NPI assigned

Jun 1, 2010

Last updated

Jun 1, 2010By the provider in NPPES

Organization subpart

Yes

Parent organization

PAVON FAMILY DENTISTRY P.S.C.As reported in NPPES

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

Authorized official

Name

Dr. Hugo Pavon, D.M.D.NPI 1609864776

Title

President

Phone

(502) 326-0789

Specialties & licenses 1

Addresses

Other names 1

• Portland Dental Center and Broadway Dental Doing business as

Part of

Pavon Family Dentistry PSC

Practitioners 1

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.

• Hugo Pavon, D.M.D.

  • General Practice Dentistry
  • Louisville, KY
  • NPI 1609864776
  NPD (past) Authorized official

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275350400000",
    "number": "1073833059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 GLENFIELD CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402412513",
            "telephone_number": "502-326-0789",
            "fax_number": "502-425-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 N 26TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402121449",
            "telephone_number": "502-778-7767",
            "fax_number": "502-778-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVON FAMILY DENTISTRY P.S.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PAVON FAMILY DENTISTRY P.S.C.",
        "enumeration_date": "2010-06-01",
        "last_updated": "2010-06-01",
        "status": "A",
        "authorized_official_last_name": "PAVON",
        "authorized_official_first_name": "HUGO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-326-0789",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "6711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portland Dental Center and Broadway Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kevin Todd Pavelonis, B.A.D.C.
• Erik S Pavlak
• Jennifer Pavlat, OTRL
• Nicholas Thales Pavlatos, MD
• Ruben Pavlov, LCADC
• Hugo Pavon, D.M.D.
• Pushpa Pavuluri, M.D.
• Mary Ellen Pawley, RN MSN APRN BC FNP
• Sydney Pawley, PT, DPT
• Pax House Inc.

• General Practice Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2010; 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.