NPIMap

Organization Active NPI

Dentistry for Children

  • Pediatric Dentistry
  • Georgetown, KY
National Provider Identifier
1083807945
Registry record updated Jul 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
DENTISTRY FOR CHILDREN
Practice address
205 Champion Way
Suite 9
Georgetown, KY 40324-8862
Phone
(502) 868-9300
NPI assigned
Aug 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2013

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

Authorized official

Name
Erin Gobble
Title
Office Manager
Phone
(502) 868-9300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

205 Champion Way
Suite 9
Georgetown, KY 40324-8862

Mailing address

216 Fountain CT
Suite#150
Lexington, KY 40509-1888
Phone (859) 543-2242

Other identifiers 1

IdentifierTypeStateIssuer
7100169540MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Dentistry for Children5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372809600000",
    "number": "1083807945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 FOUNTAIN CT",
            "address_2": "SUITE#150",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091888",
            "telephone_number": "859-543-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 CHAMPION WAY",
            "address_2": "SUITE 9",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403248862",
            "telephone_number": "502-868-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTRY FOR CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-23",
        "last_updated": "2013-07-03",
        "status": "A",
        "authorized_official_last_name": "GOBBLE",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "502-868-9300"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100169540",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; 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.