Individual provider Active NPI

Ricardo Caicedo, DMD, DDS

  • Endodontics
  • Louisville, KY
National Provider Identifier
1306958673
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
8318 Issued in KY
Practice address
University of Louisville School of Dentistry
501 S. Preston St.
Louisville, KY 40292-0001
Phone
(502) 852-5128
Fax
(502) 852-7163
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 8318 KY Primary

Addresses

Primary practice location

University of Louisville School of Dentistry
501 S. Preston St.
Louisville, KY 40292-0001

Mailing address

University of Louisville School of Dentistry
501 S. Preston St.
Louisville, KY 40292-0001
Phone (502) 852-5128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160815002587 KY Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 6305038290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8318KYMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306958673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF LOUISVILLE SCHOOL OF DENTISTRY",
            "address_2": "501 S. PRESTON ST.",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402920001",
            "telephone_number": "502-852-5128",
            "fax_number": "502-852-7163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF LOUISVILLE SCHOOL OF DENTISTRY",
            "address_2": "501 S. PRESTON ST.",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402920001",
            "telephone_number": "502-852-5128",
            "fax_number": "502-852-7163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAICEDO",
        "first_name": "RICARDO",
        "name_prefix": "Dr.",
        "credential": "DMD, DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "KY",
            "license": "8318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.