NPIMap

Organization Active NPI

Dental Health Professionals of Kentucky, P.S.C.

  • General Practice Dentistry
  • Louisville, KY
National Provider Identifier
1295563815
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL HEALTH PROFESSIONALS OF KENTUCKY, P.S.C.
Practice address
9901 Brownsboro Rd Ste 102
Louisville, KY 40241-1100
Phone
(502) 212-7655
NPI assigned
Jul 24, 2024
Organization subpart
Yes
Parent organization
DENTAL HEALTH PROFESSIONALS OF KENTUCKY, P.S.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Cemyira McDougal
Title
Credentialing Coordinator
Phone
(217) 764-8609

Specialties & licenses 1

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

Addresses

Primary practice location

9901 Brownsboro Rd Ste 102
Louisville, KY 40241-1100

Mailing address

9901 Brownsboro Rd Ste 102
Louisville, KY 40241-1100

Other names 1

  • Brownsboro Station Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of Kentucky - Mathew Cliburn DMD PSC19 organizations share this tax ID, including this one
Part of
Heartland Dental Care of Kentucky - Mathew Cliburn DMD PSC

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

9901 Brownsboro Rd
Ste 102
Louisville, KY 40241
Phone (502) 212-7655

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1295563815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 BROWNSBORO RD STE 102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402411100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 BROWNSBORO RD STE 102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402411100",
            "telephone_number": "502-212-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL HEALTH PROFESSIONALS OF KENTUCKY, P.S.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL HEALTH PROFESSIONALS OF KENTUCKY, P.S.C.",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "MCDOUGAL",
        "authorized_official_first_name": "CEMYIRA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-764-8609"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brownsboro Station Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 24, 2024; 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.