Active NPI
Adrienne Lashae Childress, DMD
- General Practice Dentistry
- Richmond, KY
National Provider Identifier
1376037341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 10129
- Practice address
- 4095 Atwood Dr Ste a
Richmond, KY 40475-8325 - Phone
- (859) 623-1700
- NPI assigned
- Jun 21, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 10129 | KY | Primary |
Addresses
Primary practice location
4095 Atwood Dr Ste a
Richmond, KY 40475-8325
Mailing address
PO Box 1658
Mount Vernon, KY 40456-1658
Phone (606) 308-5045
Other practice location 1
614 E Main St
Stanford, KY 40484-1403
Phone (606) 365-8994
Other practice location 2
1183 Stanford Rd
Lancaster, KY 40444-9567
Phone (859) 792-4236
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10129 | KY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Dynamics LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Complete Family Dentistry and Dental Associates of Richmond
- Dental Clinic/Center
- Lancaster, KY
- NPI 1558564385
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529539200000",
"number": "1376037341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1658",
"city": "MOUNT VERNON",
"state": "KY",
"postal_code": "404561658",
"telephone_number": "606-308-5045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4095 ATWOOD DR STE A",
"city": "RICHMOND",
"state": "KY",
"postal_code": "404758325",
"telephone_number": "859-623-1700"
}
],
"practiceLocations": [
{
"address_1": "614 E Main St",
"address_purpose": "LOCATION",
"city": "Stanford",
"state": "KY",
"postal_code": "404841403",
"country_code": "US",
"telephone_number": "606-365-8994",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1183 Stanford Rd",
"address_purpose": "LOCATION",
"city": "Lancaster",
"state": "KY",
"postal_code": "404449567",
"country_code": "US",
"telephone_number": "859-792-4236",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHILDRESS",
"first_name": "ADRIENNE",
"middle_name": "LASHAE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-21",
"last_updated": "2018-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "10129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.