NPIMap

Organization Active NPI

William E Shores Jr PSC

  • Dentist
  • Lexington, KY
National Provider Identifier
1134493893
Registry record updated Feb 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5707 Issued in KY
Legal business name
WILLIAM E SHORES JR PSC
Practice address
3122 Custer Dr
Ste B
Lexington, KY 40517-4000
Phone
(859) 273-2224
Fax
(859) 273-3725
NPI assigned
Feb 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2012

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

Authorized official

Name
Dr. William E Shores Jr., D.M.D.
Title
President
Phone
(859) 273-2224

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 5707 KY Primary

Addresses

Primary practice location

3122 Custer Dr
Ste B
Lexington, KY 40517-4000

Mailing address

3122 Custer Dr
Ste B
Lexington, KY 40517-4000
Phone (859) 273-2224

Other identifiers 1

IdentifierTypeStateIssuer
60057072MedicaidKY

National Provider Directory

National Provider Directory

Locations

3122 Custer Dr
Ste B
Lexington, KY 40517
Phone (859) 273-2224

NPI Registry JSON

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

{
    "created_epoch": "1330387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330387200000",
    "number": "1134493893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3122 CUSTER DR",
            "address_2": "STE B",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174000",
            "telephone_number": "859-273-2224",
            "fax_number": "859-273-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3122 CUSTER DR",
            "address_2": "STE B",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174000",
            "telephone_number": "859-273-2224",
            "fax_number": "859-273-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM E SHORES JR PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-28",
        "last_updated": "2012-02-28",
        "status": "A",
        "authorized_official_last_name": "SHORES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-273-2224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "KY",
            "license": "5707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60057072",
            "state": "KY"
        }
    ],
    "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 Feb 28, 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.