Foundational Dental Limited Liability Company

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

FOUNDATIONAL DENTAL LIMITED LIABILITY COMPANY

Doing business as

Eagle Creek Dental Associates

Practice address

180 Prosperous PL Ste 101
Lexington, KY 40509-1845

Phone

(270) 339-4583

NPI assigned

Aug 16, 2023

Last updated

Aug 16, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ryan Glenn WhiteNPI 1366225005

Title

Managing Member

Phone

(270) 339-4583

Specialties & licenses 1

Addresses

Other names 1

• Eagle Creek Dental Associates Doing business as

Locations

Practitioners 1

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.

• Ryan White, DMD

  • General Practice Dentistry
  • Lexington, KY
  • NPI 1366225005
  NPD Authorized official

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

{
    "created_epoch": "1692144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692144000000",
    "number": "1306629050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 PROSPEROUS PL STE 101",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091845",
            "telephone_number": "270-339-4583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 PROSPEROUS PL STE 101",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091845",
            "telephone_number": "270-339-4583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATIONAL DENTAL LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "270-339-4583"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Creek Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julie Stoeckinger Foster, M.A CCC SLP
• Katherine Isabelle Foster, MD
• Fostering Brilliant Minds
• Harrison Fouch, MD
• Julie Ann Foucher, M.D., M.S.
• Fountain Court Pharmacy
• Eloise Fourie, DO
• Marius Johannes Fourie, RPH
• Amber N Fouts
• Cody Arvel Fowers, M.D.

• Dental Clinic/Center in Lexington, KY
• Providers in Lexington, KY by specialty
• Dental Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.