Blincoe & Shutt PSC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

BLINCOE & SHUTT PSC

Practice address

4122 Shelbyville Rd Ste 115
Louisville, KY 40207-3206

Phone

(502) 895-2210

Fax

(502) 895-0425

NPI assigned

Jul 10, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Glenn R. Blincoe, DMDNPI 1538284443

Title

President

Phone

(502) 895-2210

Specialties & licenses 2

Addresses

Locations

Practitioners 2

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

• Glenn R Blincoe, DMD

  • General Practice Dentistry
  • Louisville, KY
  • NPI 1538284443
  NPD Authorized official
• David L. Shutt, DMD

  • General Practice Dentistry
  • Louisville, KY
  • NPI 1487779708
  NPD

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738627200000",
    "number": "1306220140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4122 SHELBYVILLE RD STE 115",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073206",
            "telephone_number": "502-895-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4122 SHELBYVILLE RD STE 115",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073206",
            "telephone_number": "502-895-2210",
            "fax_number": "502-895-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLINCOE & SHUTT PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-10",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A",
        "authorized_official_last_name": "BLINCOE",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-895-2210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harold W Blevins, MD
• Katie Michelle Blevins, MA, BCBA, LBA
• Patty L Blevins, APRN
• Madison Bley
• Alexandra Blinchevsky, MD
• Blincoe & Shutt PSC
• Glenn R Blincoe, DMD
• Mark Andrew Bline
• Bliss Psychological Services, Inc.
• Amanda Dierking Bliss, MSN, RN, APRN

• Dentist in Louisville, KY
• Providers in Louisville, KY by specialty
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.