Individual provider Active NPI

Justin A Whitney, DMD

  • Dentist
  • Louisville, KY
National Provider Identifier
1104105576
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9833 Issued in KY
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

Updated by the provider on Mar 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
12012601AINMDDentist
9833KYMDDentist

Practice roles

OrganizationSpecialtyStatusNew 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.

Verify at the official NPI Registry.