Active NPI
Larry Marcus Elliott, DMD
- Dentist
- Lexington, KY
National Provider Identifier
1316059017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3996
- Practice address
- 620 Perimeter Dr
Suite 200
Lexington, KY 40517 - Phone
- (859) 268-2332
- Fax
- (859) 268-8746
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3996 | KY | Primary |
Addresses
Primary practice location
620 Perimeter Dr
Suite 200
Lexington, KY 40517
Mailing address
620 Perimeter Dr
Suite 200
Lexington, KY 40517
Phone (859) 268-2332
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3996 | KY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John M Falace, DMD | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Lexington, KY
- NPI 1134418353
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": "1316059017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 PERIMETER DR",
"address_2": "SUITE 200",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "40517",
"telephone_number": "859-268-2332",
"fax_number": "859-268-8746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 PERIMETER DR",
"address_2": "SUITE 200",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "40517",
"telephone_number": "859-268-2332",
"fax_number": "859-268-8746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "LARRY",
"middle_name": "MARCUS",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "3996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.