NPIMap

Organization Active NPI

Kids Dentistry-Lagrange, PLLC

  • Dental Clinic/Center
  • La Grange, KY
National Provider Identifier
1104196989
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
KIDS DENTISTRY-LAGRANGE, PLLC
Practice address
2005 S Highway 53
Suite D
La Grange, KY 40031-9109
Phone
(502) 225-6820
NPI assigned
Jan 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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

Authorized official

Name
Setphen James
Title
Cfo
Phone
(502) 254-8504

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

2005 S Highway 53
Suite D
La Grange, KY 40031-9109

Mailing address

PO Box 437169
Louisville, KY 40253-7169

National Provider Directory

National Provider Directory

Locations

2005 S Highway 53
Ste D
Lagrange, KY 40031
Phone (502) 225-6820

3510 Bardstown Rd
Louisville, KY 40218
Phone (502) 442-7185

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327017600000",
    "number": "1104196989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 437169",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402537169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 S HIGHWAY 53",
            "address_2": "SUITE D",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400319109",
            "telephone_number": "502-225-6820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS DENTISTRY-LAGRANGE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-20",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "SETPHEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-254-8504"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; 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.