Georgetown Family Dentistry, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GEORGETOWN FAMILY DENTISTRY, LLC

Practice address

227 E Main St
Georgetown, KY 40324-1711

Phone

(502) 753-0609

NPI assigned

Jun 11, 2020

Last updated

Jun 11, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tristan Thompson, DMD

Title

Owner

Phone

(270) 485-6862

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1144845439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 E MAIN ST",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403241711",
            "telephone_number": "502-753-0609",
            "fax_number": "502-753-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 E MAIN ST",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403241711",
            "telephone_number": "502-753-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGETOWN FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-11",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "TRISTAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-485-6862",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Georgetown Medical, LLC

• General Practice Dentistry in Georgetown, KY
• Providers in Georgetown, 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 Jun 11, 2020; 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.