Kentuckiana Peds Dre LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

KENTUCKIANA PEDS DRE LLC

Practice address

211 High Point CT Ste 200
Mt Washington, KY 40047-5528

Phone

(502) 538-2400

NPI assigned

Nov 17, 2023

Last updated

Nov 17, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elizabeth Davis

Title

Director of Revenue

Phone

(859) 533-1109

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1700179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1093580219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SPRUCE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405072109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 HIGH POINT CT STE 200",
            "city": "MT WASHINGTON",
            "state": "KY",
            "postal_code": "400475528",
            "telephone_number": "502-538-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKIANA PEDS DRE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-17",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE",
        "authorized_official_telephone_number": "859-533-1109"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Anne Hughes (Hughes Family Dentistry)
• Jarred Kelley, LPCC
• Monna Jean Kendrick, LPCC
• Crystal Kenney, LSW
• Kentuckiana Pediatric Dentistry
• Kibbe Orthopedics PLLC (Kentucky Orthopedics & Sports Medicine)
• Shane Jacob Kibbe, MD
• Carrie Kidwell, COTA/L
• Kiosk Medicine Kentucky LLC
• Daniel Bruce Kischnick, M.D.

• Pediatric Dentistry in Mt Washington, KY
• Providers in Mt Washington, KY by specialty
• Pediatric Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.