NPIMap

Organization Active NPI

Dental Services of Kentucky, PSC

Doing business as ImmediaDent

  • General Practice Dentistry
  • Louisville, KY
National Provider Identifier
1194238816
Registry record updated Nov 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL SERVICES OF KENTUCKY, PSC
Doing business as
ImmediaDent
Practice address
2011 Grinstead Dr Unit 102
Louisville, KY 40204-1296
Phone
(502) 638-2377
Fax
(913) 752-9116
NPI assigned
Nov 16, 2017
Last updated
Nov 16, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL SERVICES OF KENTUCKY, PSCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 16, 2017

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

Authorized official

Name
Monica L Long
Title
Manager of Credentialing
Phone
(913) 428-1686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

2011 Grinstead Dr Unit 102
Louisville, KY 40204-1296

Mailing address

PO Box 11568
Overland Park, KS 66207-4268
Phone (913) 428-1686

Other names 1

  • ImmediaDent Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Services of Louisville PSC10 organizations share this tax ID, including this one
Part of
Dental Services of Louisville PSC

Other organizations with this tax ID 9

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510790400000",
    "number": "1194238816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11568",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662074268",
            "telephone_number": "913-428-1686",
            "fax_number": "913-752-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 GRINSTEAD DR UNIT 102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041296",
            "telephone_number": "502-638-2377",
            "fax_number": "913-752-9116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SERVICES OF KENTUCKY, PSC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL SERVICES OF KENTUCKY, PSC",
        "enumeration_date": "2017-11-16",
        "last_updated": "2017-11-16",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER OF CREDENTIALING",
        "authorized_official_telephone_number": "913-428-1686"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ImmediaDent",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 16, 2017; 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.