Active NPI
Triple Crown Dentistry
- General Practice Dentistry
- Louisville, KY
National Provider Identifier
1205366846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9076
- 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 DENTISTRY
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9076 | KY | Primary |
| General Practice Dentistry | 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.
-
- General Practice Dentistry
- Louisville, KY
- NPI 1437596954
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.