Peter Frank Alena, DMD

Individual provider Active NPI General Practice Dentistry · Louisville, KY

NPI 1326530965 · NPPES record last updated Oct 4, 2018

Key facts

NPI
1326530965
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
10092 (KY)
Practice address
501 S Preston St RM 148
Louisville, KY 40202-1701
Phone
(502) 852-5838
NPI assigned
May 30, 2018
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20180829002588 KY Order and Referring Only - Dentist
Practitioner - Dentist
8921358797

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 10092 KY
General Practice Dentistry 1223G0001X 10092 KY Yes

Addresses

Primary practice location

501 S Preston St RM 148
Louisville, KY 40202-1701

Mailing address

925 Ardmore Dr
Louisville, KY 40217-2338
Phone (770) 401-5541

Other providers in Louisville, KY

All providers in Louisville, KY · General Practice Dentistry in Kentucky

Sources for this page

Verify at the official NPI Registry.