Blystone Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BLYSTONE DENTAL PLLC

Practice address

642 Baxter Ave Ste 110
Louisville, KY 40204-1795

Phone

(502) 208-9385

NPI assigned

May 15, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Ailey Blystone, DDSNPI 1790378875

Title

Practice Owner

Phone

(270) 234-7624

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Ailey L. Blystone

  • Dentist
  • Crescent Springs, KY
  • NPI 1790378875
  NPD Authorized official

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1104675875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 KENTUCKY OAKS TRL",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427014483",
            "telephone_number": "270-234-7624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 BAXTER AVE STE 110",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041795",
            "telephone_number": "502-208-9385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLYSTONE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "BLYSTONE",
        "authorized_official_first_name": "AILEY",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "270-234-7624",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Kristen Blume, APRN
• Angie Marrie Blunk, ND
• Christian Blunk, RBT
• Stephanie A Blunk, COTA/L
• Mary Elizabeth Bluthardt, PHARMD, MBA
• Jenna Marcum Blyth, SLP
• Johanna Ariel Blythe Reske, MD
• Diane Blythe, PTA
• BN Specialty, LLC
• Fiona S Boak, O.D.

• All providers in Louisville, KY
• Dental Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.