Jeremy L Fairbourn DDS, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9270 Issued in KY

Legal business name

JEREMY L FAIRBOURN DDS, PLLC

Practice address

207 Alpine Dr
Shelbyville, KY 40065-8881

Phone

(502) 633-3900

NPI assigned

Dec 17, 2012

Last updated

Dec 17, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeremy Lynn Fairbourn, D.D.S.NPI 1750695037

Title

Member

Phone

(502) 633-3900

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeremy Lynn Fairbourn, DDS

  • General Practice Dentistry
  • Shelbyville, KY
  • NPI 1750695037
  Authorized official Same address or phone
• Lisa L Daugherty, D.M.D

  • General Practice Dentistry
  • Shelbyville, KY
  • NPI 1083625347
  NPD (past)

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355702400000",
    "number": "1396081576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 ALPINE DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 ALPINE DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658881",
            "telephone_number": "502-633-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMY L FAIRBOURN DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-17",
        "last_updated": "2012-12-17",
        "status": "A",
        "authorized_official_last_name": "FAIRBOURN",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "502-633-3900",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Ann Jenkins, LCADC
• Megan Jenkins, PHYSICAL THERAPIST
• Casey Mae Jensen, APRN
• Jean Anne Jensen, DMD, MS
• Travis Dean Jent, PHARMD
• Jewish Hospital & St. Mary's Healthcare, Inc. (Jewish Hospital Shelbyville Skilled Nursing Facility)
• Jewish Hospital & St. Mary's Healthcare, Inc. (Jewish Hospital Shelbyville)
• Jewish Hospital & St. Mary's Healthcare, Inc. (Jewish Hospital Shelbyville)
• Jewish Hospital & St. Mary's Healthcare, Inc.
• Ryan Johns

• General Practice Dentistry in Shelbyville, KY
• Providers in Shelbyville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; 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.