Active NPI
Ronald Judson Pryor, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Louisville, KY
National Provider Identifier
1205903838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 4067
- Practice address
- 4040 Dixie Highway
Suite 102
Louisville, KY 40216 - Phone
- (502) 447-2456
- Fax
- (502) 447-5453
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 4067 | KY | Primary |
Addresses
Primary practice location
4040 Dixie Highway
Suite 102
Louisville, KY 40216
Mailing address
4040 Dixie Highway
Suite 102
Louisville, KY 40216
Phone (502) 447-2456
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51024 | Medicaid | IN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4067 | KY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205903838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4040 DIXIE HIGHWAY",
"address_2": "SUITE 102",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "40216",
"telephone_number": "502-447-2456",
"fax_number": "502-447-5453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4040 DIXIE HIGHWAY",
"address_2": "SUITE 102",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "40216",
"telephone_number": "502-447-2456",
"fax_number": "502-447-5453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRYOR",
"first_name": "RONALD",
"middle_name": "JUDSON",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "KY",
"license": "4067",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "51024",
"state": "IN"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.