V.S. Degeorge, DMD, PSC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

3550 Issued in KY

Legal business name

V.S. DEGEORGE, DMD, PSC

Practice address

8013 New Lagrange Road
Suite #3
Louisville, KY 40222-4077

Phone

(502) 426-4868

Fax

(502) 426-4869

NPI assigned

Jan 23, 2012

Organization subpart

No

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

Authorized official

Name

Victor S Degeorge, DMDNPI 1801936620

Title

Orthodontist

Phone

(502) 426-4868

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Victor Sebastian Degeorge, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Louisville, KY
  • NPI 1801936620
  NPD (past) Authorized official

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327276800000",
    "number": "1194096115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8013 NEW LAGRANGE ROAD",
            "address_2": "SUITE #3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224077",
            "telephone_number": "502-426-4868",
            "fax_number": "502-426-4869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8013 NEW LAGRANGE ROAD",
            "address_2": "SUITE #3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224077",
            "telephone_number": "502-426-4868",
            "fax_number": "502-426-4869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "V.S. DEGEORGE, DMD, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-23",
        "last_updated": "2012-01-23",
        "status": "A",
        "authorized_official_last_name": "DEGEORGE",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "502-426-4868",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "KY",
            "license": "3550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60035508",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; 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.