TDS Ky Four, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

TDS KY FOUR, LLC

Practice address

8511 Terry Rd
Louisville, KY 40258-1751

Phone

(812) 569-2955

NPI assigned

Oct 18, 2019

Organization subpart

No

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

Authorized official

Name

Adrienne Nicholson

Title

Regional Manager

Phone

(812) 569-2955

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1164065488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8511 TERRY RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402581751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8511 TERRY RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402581751",
            "telephone_number": "812-569-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TDS KY FOUR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-18",
        "last_updated": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "ADRIENNE",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "812-569-2955"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adi@derekgarciadental.com",
            "affiliation": "Y",
            "affiliationName": "TDS Ky Two",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8511 Terry Rd",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402581751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• TBD Acquisition LLC
• TBD Acquisition, LLC
• TBS Dental PLLC
• TD Ky One LLC
• TDS Ky Five
• TDS Ky Two
• Jessica Teachout, RN
• Rod-Janae D Teagle, RBT
• Barrett M Teague, APRN
• Nicole Teague

• Dental Clinic/Center in Louisville, KY
• Providers in Louisville, KY by specialty
• Dental Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.