Individual provider Active NPI

David A Rougeux, DMD

  • Pediatric Dentistry
  • Louisville, KY
National Provider Identifier
1316935570
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
6253 Issued in KY
Practice address
3934 Dixie Hwy
Suite 430
Louisville, KY 40216-4163
Phone
(502) 449-1723
Fax
(502) 448-7488
NPI assigned
Oct 12, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 6253 KY Primary
Dentist 122300000X 6253 KY

Addresses

Primary practice location

3934 Dixie Hwy
Suite 430
Louisville, KY 40216-4163

Mailing address

3934 Dixie Hwy
430
Louisville, KY 40216-4163
Phone (502) 449-1723

Other identifiers 1

IdentifierTypeStateIssuer
4581MedicaidKY

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

LicenseStateTypeSpecialty
6253KYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1316935570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3934 DIXIE HWY",
            "address_2": "430",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402164163",
            "telephone_number": "502-449-1723",
            "fax_number": "502-448-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3934 DIXIE HWY",
            "address_2": "SUITE 430",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402164163",
            "telephone_number": "502-449-1723",
            "fax_number": "502-448-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUGEUX",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "6253",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "6253",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4581",
            "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 Nov 5, 2013; 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.