Individual provider Active NPI

Leslie S Neville, D.M.D.

  • General Practice Dentistry
  • Horse Cave, KY
National Provider Identifier
1194914374
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8533 Issued in KY
Practice address
311 S Dixie St
Horse Cave, KY 42749-1230
Phone
(270) 786-2547
Fax
(270) 786-4576
NPI assigned
Oct 23, 2007
Last updated
Jun 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8533 KY Primary

Addresses

Primary practice location

311 S Dixie St
Horse Cave, KY 42749-1230

Mailing address

311 S Dixie St
P. O. Box 324
Horse Cave, KY 42749-1230
Phone (270) 786-2547

Other identifiers 1

IdentifierTypeStateIssuer
7100025030MedicaidKY

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
I20150521001176 KY Order and Referring Only - DentistPractitioner - Dentist 1951621515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8533KYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Neville Dental Studio General Practice CurrentSince Nov 9, 2021 Accepting new patients
Dr. Steven P. Neville, DMD, PSC General Practice Past Accepting new patients

Locations

155 Olde Towne Blvd
Bowling Green, KY 42103
Phone (270) 715-2978

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1194914374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S DIXIE ST",
            "address_2": "P. O. BOX 324",
            "city": "HORSE CAVE",
            "state": "KY",
            "postal_code": "427491230",
            "telephone_number": "270-786-2547",
            "fax_number": "270-786-4576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S DIXIE ST",
            "city": "HORSE CAVE",
            "state": "KY",
            "postal_code": "427491230",
            "telephone_number": "270-786-2547",
            "fax_number": "270-786-4576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVILLE",
        "first_name": "LESLIE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-23",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "8533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100025030",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Horse Cave, KY

Sources for this page

Verify at the official NPI Registry.