Pauletta G Baughman, DMD
Individual provider Active NPI General Practice Dentistry · Louisville, KY
NPI 1104951672 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104951672
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 5332 (KY)
- Practice address
- 4515 Churchman Ave
Louisville, KY 40215-1109 - Phone
- (502) 361-0637
- Fax
- (502) 361-0636
- NPI assigned
- Feb 23, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5332 | KY | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5332 | KY | Yes |
Addresses
Primary practice location
4515 Churchman Ave
Louisville, KY 40215-1109
Mailing address
4515 Churchman Ave
Louisville, KY 40215-1109
Phone (502) 361-0637
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5332 | Other | KY | STATE LICENSE NUMBER |
Other providers in Louisville, KY
- Lauren Renae Bauer
- Patricia Bauer
- Kevin Richard Bauereis
- Jasmine Baugh
- Katherine E Baughman
- Craig Steve Baum
- Tammy M Baum
- Carl N. Bauman
- Chad Bauman
- Chase Bauman
All providers in Louisville, KY · General Practice Dentistry in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.