Individual provider Active NPI

Liliani Aires Candido Vieira

  • General Practice Dentistry
  • Louisville, KY
National Provider Identifier
1194568816
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11088 Issued in KY
Practice address
501 S Preston St
Louisville, KY 40202-1701
Phone
(502) 852-5096
NPI assigned
Jun 18, 2024
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11088 KY
General Practice Dentistry 1223G0001X 11088 KY Primary

Addresses

Primary practice location

501 S Preston St
Louisville, KY 40202-1701

Mailing address

2331 Saratoga Dr
Louisville, KY 40205-2020
Phone (502) 790-4091

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11088KYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1194568816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 SARATOGA DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402052020",
            "telephone_number": "502-790-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S PRESTON ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021701",
            "telephone_number": "502-852-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AIRES CANDIDO VIEIRA",
        "first_name": "LILIANI",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "11088",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "11088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 28, 2024; 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.