NPIMap

Organization Active NPI

Morehead Pediatric Dentistry, PLLC

  • Pediatric Dentistry
  • Morehead, KY
National Provider Identifier
1326474099
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
9075 Issued in KY
Legal business name
MOREHEAD PEDIATRIC DENTISTRY, PLLC
Practice address
1275 Hallwood Drive
Morehead, KY 40351
Phone
(606) 776-9863
NPI assigned
Sep 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

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

Authorized official

Name
Dr. Brent Douglas Kidd, D.M.D.NPI 1255622692
Title
Owner/Operator
Phone
(606) 776-9863

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 9075 KY Primary

Addresses

Primary practice location

1275 Hallwood Drive
Morehead, KY 40351

Mailing address

6927 Woodhaven Place Dr
Louisville, KY 40228-2804
Phone (606) 776-9863

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1380067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1326474099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6927 WOODHAVEN PLACE DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402282804",
            "telephone_number": "606-776-9863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 HALLWOOD DRIVE",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "40351",
            "telephone_number": "606-776-9863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOREHEAD PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-25",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "KIDD",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "606-776-9863",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "9075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.