NPIMap

Organization Active NPI

David J, Elrod, DMD. a Professional Service Corporation

  • General Practice Dentistry
  • Paducah, KY
National Provider Identifier
1285998815
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9083 Issued in KY
Legal business name
DAVID J, ELROD, DMD. A PROFESSIONAL SERVICE CORPORATION
Practice address
5183 Hinkleville Rd
Paducah, KY 42001-9667
Phone
(270) 415-9006
NPI assigned
Jun 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

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

Authorized official

Name
Ashley Cole
Title
Provider Relations Manager
Phone
(315) 454-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 9083 KY Primary

Addresses

Primary practice location

5183 Hinkleville Rd
Paducah, KY 42001-9667

Mailing address

PO Box 3189
Syracuse, NY 13220-3189

National Provider Directory

National Provider Directory

Locations

5183 Hinkleville Rd
Paducah, KY 42001
Phone (270) 415-9006

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340841600000",
    "number": "1285998815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5183 HINKLEVILLE RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420019667",
            "telephone_number": "270-415-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID J, ELROD, DMD. A PROFESSIONAL SERVICE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-28",
        "last_updated": "2012-06-28",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "PROVIDER RELATIONS MANAGER",
        "authorized_official_telephone_number": "315-454-6000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; 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.