Individual provider Active NPI

Lauren Kayla Renaud, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • New Albany, IN
National Provider Identifier
1194219246
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
12013893A Issued in IN
Practice address
2441 State St Ste 1
New Albany, IN 47150-4962
Phone
(812) 944-8200
NPI assigned
Jun 20, 2018
Last updated
Aug 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10155 KY
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 12013893A IN Primary

Addresses

Primary practice location

2441 State St Ste 1
New Albany, IN 47150-4962

Mailing address

2441 State St Ste 1
New Albany, IN 47150-4962
Phone (812) 944-8200

Other practice location 1

1212 Hull St Apt 3
Louisville, KY 40204-1167
Phone (502) 424-3371

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
I20180822002671 KY Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 5294084364

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10155KYMDDentist
12013893AINMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1194219246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 STATE ST STE 1",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504962",
            "telephone_number": "812-944-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 STATE ST STE 1",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504962",
            "telephone_number": "812-944-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1212 Hull St Apt 3",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402041167",
            "country_code": "US",
            "telephone_number": "502-424-3371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENAUD",
        "first_name": "LAUREN",
        "middle_name": "KAYLA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "10155",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IN",
            "license": "12013893A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

Verify at the official NPI Registry.