NPIMap

Organization Active NPI

Dental Health Professionals of Kentucky, P.S.C

  • General Practice Dentistry
  • Louisville, KY
National Provider Identifier
1194393546
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL HEALTH PROFESSIONALS OF KENTUCKY, P.S.C
Practice address
301 E Main St Ste 102
Louisville, KY 40202-1243
Phone
(502) 584-1322
NPI assigned
Jun 14, 2021
Organization subpart
Yes
Parent organization
DENTAL HEALTH PROFESSIONALS OF KENTUCKY, P.S.CAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Authorized official

Name
Tabatha Lemke
Title
Credentialing Coordinator
Phone
(217) 540-6078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

301 E Main St Ste 102
Louisville, KY 40202-1243

Mailing address

301 E Main St Ste 102
Louisville, KY 40202-1243

Other names 1

  • Metro Dental Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of Kentucky - Mathew Cliburn DMD PSC19 organizations share this tax ID, including this one
Part of
Heartland Dental Care of Kentucky - Mathew Cliburn DMD PSC

Other organizations with this tax ID 18

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

View all 18

Locations

301 E Main St
Ste 102
Louisville, KY 40202
Phone (502) 584-1322

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1194393546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST STE 102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST STE 102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021243",
            "telephone_number": "502-584-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL HEALTH PROFESSIONALS OF KENTUCKY, P.S.C",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL HEALTH PROFESSIONALS OF KENTUCKY, P.S.C",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "LEMKE",
        "authorized_official_first_name": "TABATHA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-6078"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Dental Group",
            "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 Jun 14, 2021; 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.