Specialized Dental Services.PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SPECIALIZED DENTAL SERVICES.PLLC

Doing business as

Kid's Dentistry
Kids Dentistree - Middletown

Practice address

130 Evergreen Rd
Louisville, KY 40243-1489

Phone

(502) 410-1710

Fax

(502) 253-2202

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Jeff Reibel

Title

Cfo

Phone

(502) 254-8500

Specialties & licenses 1

Addresses

Other names 2

• Kid's Dentistry Doing business as
• Kids Dentistree - Middletown 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.

• Mitisha Nichole Martin, DMD

  • Dentist
  • Louisville, KY
  • NPI 1255592267
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1316059934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 437169",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402537169",
            "telephone_number": "502-245-7103",
            "fax_number": "502-253-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 EVERGREEN RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431489",
            "telephone_number": "502-410-1710",
            "fax_number": "502-253-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED DENTAL SERVICES.PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "REIBEL",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-254-8500"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kid's Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kids Dentistree - Middletown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialized Dental Services-Iroquois Park, PLLC
• Specialized Dental Services-Jefferson Mall, PLLC
• Specialty Anesthesia, LLC
• Specialty Orthopaedics PSC
• Specialty Orthopaedics PSC (Kentuckiana Foot & Ankle Sports Medicine)
• Specialty Orthopaedics, PSC
• Brittany Spector

• Dental Clinic/Center in Louisville, KY
• Providers in Louisville, 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 Sep 6, 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.