Organization Active NPI

Lincoln Trail Dental, PLLC

  • Dental Clinic/Center
  • Elizabethtown, KY
National Provider Identifier
1184364036
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
LINCOLN TRAIL DENTAL, PLLC
Doing business as
Lincoln Trail Dental, PLLC
Practice address
2736 Ring Rd
Elizabethtown, KY 42701-9151
Phone
(270) 765-5597
NPI assigned
Mar 30, 2022
Last updated
Mar 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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

Authorized official

Name
Dr. Christopher Glenn Nichols, DMD
Title
Owner
Phone
(270) 505-5066

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

2736 Ring Rd
Elizabethtown, KY 42701-9151

Mailing address

2736 Ring Rd
Elizabethtown, KY 42701-9151
Phone (270) 765-5597

Other names 1

  • Lincoln Trail Dental, PLLC Doing business as

National Provider Directory

National Provider Directory

Locations

2736 Ring Rd
Elizabethtown, KY 42701
Phone (270) 765-5597

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648598400000",
    "number": "1184364036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2736 RING RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427019151",
            "telephone_number": "270-765-5597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2736 RING RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427019151",
            "telephone_number": "270-765-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN TRAIL DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-505-5066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lincoln Trail Dental, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.