Active NPI
Justin A Whitney, DMD
- Dentist
- Louisville, KY
National Provider Identifier
1104105576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9833
- Practice address
- 501 S Preston St
Louisville, KY 40202 - Phone
- (502) 852-5128
- NPI assigned
- Aug 16, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9833 | KY | Primary |
| Dentist | 122300000X | 12012601A | IN |
Addresses
Primary practice location
501 S Preston St
Louisville, KY 40202
Mailing address
7211 E Orchard Grass Blvd
Crestwood, KY 40014-8561
Other practice location 1
1005 E Lewis and Clark Pkwy
Clarksville, IN 47129-2201
Phone (812) 280-7500
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12012601A | IN | MD | Dentist |
| 9833 | KY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RG Dental Jeffersonville LLC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551916800000",
"number": "1104105576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7211 E ORCHARD GRASS BLVD",
"city": "CRESTWOOD",
"state": "KY",
"postal_code": "400148561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 S PRESTON ST",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "40202",
"telephone_number": "502-852-5128"
}
],
"practiceLocations": [
{
"address_1": "1005 E Lewis and Clark Pkwy",
"address_purpose": "LOCATION",
"city": "Clarksville",
"state": "IN",
"postal_code": "471292201",
"country_code": "US",
"telephone_number": "812-280-7500",
"fax_number": "812-280-8016",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHITNEY",
"first_name": "JUSTIN",
"middle_name": "A",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-16",
"last_updated": "2019-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "9833",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12012601A",
"primary": false
}
],
"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 Mar 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.