3Rd Street Family Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

3RD STREET FAMILY DENTAL

Practice address

3911 S 3Rd St
Louisville, KY 40214-1601

Phone

(502) 368-5575

Fax

(502) 368-5596

NPI assigned

Jul 6, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Kathy Degraaff

Title

President

Phone

(502) 368-5575

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.

• Fereshteh Mazhary, D.M.D.

  • General Practice Dentistry
  • Fullerton, CA
  • NPI 1376531418
  NPD (past)

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278374400000",
    "number": "1124330337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 S 3RD ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402141601",
            "telephone_number": "502-368-5575",
            "fax_number": "502-368-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 S 3RD ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402141601",
            "telephone_number": "502-368-5575",
            "fax_number": "502-368-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3RD STREET FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-06",
        "last_updated": "2010-07-06",
        "status": "A",
        "authorized_official_last_name": "DEGRAAFF",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-368-5575",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 360Care Services of Kentucky LLC
• 360Care Services of Kentucky LLC
• 360Care Services of Kentucky LLC
• 3B Enterprises LLC
• 3PL Project Purchase Planning Logistics Inc
• 4 Kings Medical Transportation LLC
• 4 Kings Transportation
• 4 Star Guidance LLC
• 4112 Fern Valley Road Ops LLC
• 4418 Malcolm Avenue Ops LLC

• General Practice Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; 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.