Individual provider Active NPI

Elizabeth Kelty McLaurin, DMD

  • Pediatric Dentistry
  • Highland Heights, KY
National Provider Identifier
1255712428
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
9655 Issued in KY
Practice address
1809 Alexandria Pike
Highland Heights, KY 41076-1155
Phone
(859) 803-0708
NPI assigned
Jun 14, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 9655 KY Primary

Addresses

Primary practice location

1809 Alexandria Pike
Highland Heights, KY 41076-1155

Mailing address

1680 Park Rd
Covington, KY 41011-2776
Phone (601) 613-7259

Other practice location 1

800 Rose Street D 538
Lexington, KY 40536-0001
Phone (859) 323-9707

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
9655KYMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1434240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1255712428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 PARK RD",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410112776",
            "telephone_number": "601-613-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 ALEXANDRIA PIKE",
            "city": "HIGHLAND HEIGHTS",
            "state": "KY",
            "postal_code": "410761155",
            "telephone_number": "859-803-0708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Rose Street D 538",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360001",
            "country_code": "US",
            "telephone_number": "859-323-9707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCLAURIN",
        "first_name": "ELIZABETH",
        "middle_name": "KELTY",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-14",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "9655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Heights, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; 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.