Organization Active NPI

Triple Crown Dentistry

  • General Practice Dentistry
  • Louisville, KY
National Provider Identifier
1205366846
Registry record updated Jun 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9076 Issued in KY
Legal business name
TRIPLE CROWN DENTISTRY
Practice address
904 Lily Creek Road
Suite 101
Louisville, KY 40243
Phone
(502) 409-4299
Fax
(502) 409-4309
NPI assigned
Jun 15, 2017
Organization subpart
Yes
Parent organization
TRIPLE CROWN DENTISTRYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 15, 2017

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

Authorized official

Name
Dr. Mary Shields, D.M.D.
Title
Owner
Phone
(502) 409-4299

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 9076 KY Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 9305 KY

Addresses

Primary practice location

904 Lily Creek Road
Suite 101
Louisville, KY 40243

Mailing address

904 Lily Creek Road
Suite 101
Louisville, KY 40243
Phone (502) 409-4299

National Provider Directory

National Provider Directory
Part of
Triple Crown Dentistry

Locations

904 Lily Creek Rd
Ste 101
Louisville, KY 40243
Phone (502) 409-4299

Practitioners & affiliated clinicians

Practitioners 1

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": "1497484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497484800000",
    "number": "1205366846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 LILY CREEK ROAD",
            "address_2": "SUITE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40243",
            "telephone_number": "502-409-4299",
            "fax_number": "502-409-4309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 LILY CREEK ROAD",
            "address_2": "SUITE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40243",
            "telephone_number": "502-409-4299",
            "fax_number": "502-409-4309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIPLE CROWN DENTISTRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRIPLE CROWN DENTISTRY",
        "enumeration_date": "2017-06-15",
        "last_updated": "2017-06-15",
        "status": "A",
        "authorized_official_last_name": "SHIELDS",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-409-4299",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9076",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9305",
            "primary": false
        }
    ],
    "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 Jun 15, 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.