East Louisville Oral Surgery and Dental Implants PLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

EAST LOUISVILLE ORAL SURGERY AND DENTAL IMPLANTS PLC

Practice address

1013 N Dupont SQ Ste B
Louisville, KY 40207-4612

Phone

(502) 897-5282

Fax

(502) 896-6714

NPI assigned

Dec 16, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth W Livesay Jr., DMDNPI 1558390724

Title

Member

Phone

(502) 897-5282

Specialties & licenses 2

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth W Livesay Jr., DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Louisville, KY
  • NPI 1558390724
  NPD Authorized official
• Thomas Bailey, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Franklin, TN
  • NPI 1144649393
  NPD
• Austin Ray Carey, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Louisville, KY
  • NPI 1144607920
  NPD (past)

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691971200000",
    "number": "1275292377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 N DUPONT SQ STE B",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074612",
            "telephone_number": "502-897-5282",
            "fax_number": "502-896-6714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 N DUPONT SQ STE B",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074612",
            "telephone_number": "502-897-5282",
            "fax_number": "502-896-6714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4181 New Shepherdsville Rd",
            "address_purpose": "LOCATION",
            "city": "Bardstown",
            "state": "KY",
            "postal_code": "400049021",
            "country_code": "US",
            "telephone_number": "502-305-3649",
            "fax_number": "502-373-6562",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Middletown Park Pl Ste A",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402432541",
            "country_code": "US",
            "telephone_number": "502-254-3818",
            "fax_number": "502-254-3819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAST LOUISVILLE ORAL SURGERY AND DENTAL IMPLANTS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-16",
        "last_updated": "2023-08-14",
        "certification_date": "2023-07-19",
        "status": "A",
        "authorized_official_last_name": "LIVESAY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "502-897-5282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Louisville Dermatology, PSC
• East Louisville Inpatient Medicine, PLLC
• East Louisville Interventional Pain Specialists PLLC
• East Louisville Interventional Pain Specialists, PLLC
• East Louisville Neurology, PSC
• East Louisville Oral Surgery and Dental Implants PLC
• East Louisville Pathologists PSC
• East Louisville Pediatrics, P.S.C.
• East Louisville Speech Therapy, LLC
• East Tennessee Wound Care PC

• Oral and Maxillofacial Surgery (Dentist) in Louisville, KY
• Providers in Louisville, KY by specialty
• Oral and Maxillofacial Surgery (Dentist) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.