NPIMap

Organization Active NPI

Dentistry for Children

  • Pediatric Dentistry
  • Richmond, KY
National Provider Identifier
1184729873
Registry record updated Jul 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
DENTISTRY FOR CHILDREN
Practice address
1012 Ival James Blvd
Suite C
Richmond, KY 40475-8174
Phone
(859) 626-9620
Fax
(859) 626-9622
NPI assigned
Sep 14, 2006
Last updated
Jul 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2013

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

Authorized official

Name
Erin Gobble
Title
Office Manager
Phone
(859) 626-9620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X Primary

Addresses

Primary practice location

1012 Ival James Blvd
Suite C
Richmond, KY 40475-8174

Mailing address

1012 Ival James Blvd
Suite C
Richmond, KY 40475-8174
Phone (859) 626-9620

Other identifiers 1

IdentifierTypeStateIssuer
61901088MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Dentistry for Children5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372809600000",
    "number": "1184729873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 IVAL JAMES BLVD",
            "address_2": "SUITE C",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758174",
            "telephone_number": "859-626-9620",
            "fax_number": "859-626-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 IVAL JAMES BLVD",
            "address_2": "SUITE C",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758174",
            "telephone_number": "859-626-9620",
            "fax_number": "859-626-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTRY FOR CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2013-07-03",
        "status": "A",
        "authorized_official_last_name": "GOBBLE",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "859-626-9620"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61901088",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; 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.