NPIMap

Organization Active NPI

Mattingly Orthodontics PSC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Louisville, KY
National Provider Identifier
1316921703
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
7289 Issued in KY
Legal business name
MATTINGLY ORTHODONTICS PSC
Practice address
1013 Dupont SQ N
Louisville, KY 40207-4612
Phone
(502) 895-3473
Fax
(502) 897-3795
NPI assigned
Nov 30, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Authorized official

Name
Dr. Chris L Mattingly, DMDNPI 1568586048
Title
Vice President
Phone
(502) 895-3473

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 7289 KY Primary

Addresses

Primary practice location

1013 Dupont SQ N
Louisville, KY 40207-4612

Mailing address

1013 Dupont SQ N
Louisville, KY 40207-4612
Phone (502) 895-3473

Other identifiers 1

IdentifierTypeStateIssuer
60063435MedicaidKY

National Provider Directory

National Provider Directory

Locations

1013 N DuPont Sq
Louisville, KY 40207
Phone (502) 895-3473

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1316921703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 DUPONT SQ N",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074612",
            "telephone_number": "502-895-3473",
            "fax_number": "502-897-3795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 DUPONT SQ N",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074612",
            "telephone_number": "502-895-3473",
            "fax_number": "502-897-3795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTINGLY ORTHODONTICS PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-30",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "MATTINGLY",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "502-895-3473",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "KY",
            "license": "7289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60063435",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.