Individual provider Active NPI

Tammy Elizabeth Graham-Fortune, DMD

  • General Practice Dentistry
  • Louisville, KY
National Provider Identifier
1396740247
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7279 Issued in KY
Practice address
9001 Galene Dr
Louisville, KY 40299-1521
Phone
(502) 267-8176
Fax
(502) 267-8177
NPI assigned
Jun 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7279 KY Primary

Addresses

Primary practice location

9001 Galene Dr
Louisville, KY 40299-1521

Mailing address

9001 Galene Dr
Louisville, KY 40299-1521
Phone (502) 267-8176

Other names 1

  • Dr. Charles Edward Graham Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151216002564 KY Order and Referring Only - DentistPractitioner - Dentist 9335440346

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7279KYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Graham and Fortune, PLLC General Practice 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1396740247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9001 GALENE DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402991521",
            "telephone_number": "502-267-8176",
            "fax_number": "502-267-8177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 GALENE DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402991521",
            "telephone_number": "502-267-8176",
            "fax_number": "502-267-8177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM-FORTUNE",
        "first_name": "TAMMY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "7279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLES",
            "last_name": "GRAHAM",
            "middle_name": "EDWARD",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.