Individual provider Active NPI

Jessie C Bittner, D.M.D

  • Dentist
  • Florence, KY
National Provider Identifier
1174044390
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9992 Issued in KY
Practice address
7668 Mall Rd Unit B
Florence, KY 41042-1593
Phone
(859) 568-1900
NPI assigned
Jun 28, 2017
Last updated
Jun 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12012801A IN
Dentist 122300000X 9992 KY Primary

Addresses

Primary practice location

7668 Mall Rd Unit B
Florence, KY 41042-1593

Mailing address

7668 Mall Rd Unit B
Florence, KY 41042-1593

Other practice location 1

7668 Mall Rd Unit B
Florence, KY 41042-1593
Phone (859) 568-1900

Other practice location 2

4919 Outer Loop
Louisville, KY 40219-4051
Phone (502) 791-5594

Other practice location 3

1116 Veterans Pkwy
Clarksville, IN 47129-2370
Phone (866) 571-3409

Other practice location 4

4919 Outer Loop
Louisville, KY 40219-4051
Phone (502) 791-5594

Other practice location 5

6810 Dixie Hwy
Louisville, KY 40258-3914
Phone (502) 873-0171

Other practice location 6

220 Cassidy Blvd
Pikeville, KY 41501
Phone (606) 653-2859 ext. 2

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170825002691 KY Order and Referring Only - DentistPractitioner - Dentist 2163794157

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12012801AINMDDentist
9992KYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1174044390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7668 MALL RD UNIT B",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410421593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7668 MALL RD UNIT B",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410421593",
            "telephone_number": "859-568-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7668 Mall Rd Unit B",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "KY",
            "postal_code": "410421593",
            "country_code": "US",
            "telephone_number": "859-568-1900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4919 Outer Loop",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402194051",
            "country_code": "US",
            "telephone_number": "502-791-5594",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1116 Veterans Pkwy",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "IN",
            "postal_code": "471292370",
            "country_code": "US",
            "telephone_number": "866-571-3409",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4919 Outer Loop",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402194051",
            "country_code": "US",
            "telephone_number": "502-791-5594",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6810 Dixie Hwy",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402583914",
            "country_code": "US",
            "telephone_number": "502-873-0171",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 Cassidy Blvd",
            "address_purpose": "LOCATION",
            "city": "Pikeville",
            "state": "KY",
            "postal_code": "41501",
            "country_code": "US",
            "telephone_number": "606-653-2859 x2",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BITTNER",
        "first_name": "JESSIE",
        "middle_name": "C",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012801A",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, KY

Sources for this page

Verify at the official NPI Registry.