Active NPI
Kassandra Kulb, D.M.D
- General Practice Dentistry
- Louisville, KY
National Provider Identifier
1174869812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9169
- Practice address
- 14045 Shelbyville Rd
Louisville, KY 40245-3907 - Phone
- (502) 245-9343
- Fax
- (502) 245-9352
- NPI assigned
- Dec 28, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9169 | KY | Primary |
Addresses
Primary practice location
14045 Shelbyville Rd
Louisville, KY 40245-3907
Mailing address
14045 Shelbyville Rd
Louisville, KY 40245-3907
Phone (502) 245-9343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9169 | KY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443744000000",
"number": "1174869812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14045 SHELBYVILLE RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402453907",
"telephone_number": "502-245-9343",
"fax_number": "502-245-9352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14045 SHELBYVILLE RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402453907",
"telephone_number": "502-245-9343",
"fax_number": "502-245-9352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KULB",
"first_name": "KASSANDRA",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-28",
"last_updated": "2015-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "9169",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.