NPIMap

Organization Active NPI

Perimeter Periodontics PLLC

  • Periodontics
  • Lexington, KY
National Provider Identifier
1124327200
Registry record updated Apr 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
8167 Issued in KY
Legal business name
PERIMETER PERIODONTICS PLLC
Practice address
620 Perimeter Dr
Ste 103
Lexington, KY 40517-4125
Phone
(859) 268-1596
Fax
(859) 977-7376
NPI assigned
Mar 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2011

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

Authorized official

Name
Dr. Justin C. Clemens, DDS, MSNPI 1699975904
Title
Owner/Dentist
Phone
(859) 268-1596

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 8167 KY Primary

Addresses

Primary practice location

620 Perimeter Dr
Ste 103
Lexington, KY 40517-4125

Mailing address

620 Perimeter Dr
Ste 103
Lexington, KY 40517-4125
Phone (859) 268-1596

National Provider Directory

National Provider Directory

Locations

620 Perimeter Dr
Ste 103
Lexington, KY 40517
Phone (859) 268-1596

Practitioners & affiliated clinicians

Practitioners 2

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": "1300147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302134400000",
    "number": "1124327200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 PERIMETER DR",
            "address_2": "STE 103",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174125",
            "telephone_number": "859-268-1596",
            "fax_number": "859-977-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 PERIMETER DR",
            "address_2": "STE 103",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174125",
            "telephone_number": "859-268-1596",
            "fax_number": "859-977-7376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIMETER PERIODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-15",
        "last_updated": "2011-04-07",
        "status": "A",
        "authorized_official_last_name": "CLEMENS",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "859-268-1596",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "KY",
            "license": "8167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; 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.