NPIMap

Organization Active NPI

Kids Dentistree of Ky, LLC

  • Pediatric Dentistry
  • Louisville, KY
National Provider Identifier
1407341258
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
KIDS DENTISTREE OF KY, LLC
Doing business as
Kids Dentistree - Breckenridge
Practice address
3101 Breckenridge LN Ste 4B
Louisville, KY 40220-2797
Phone
(502) 451-1020
Fax
(502) 451-9339
NPI assigned
Jun 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Authorized official

Name
Stephen James
Title
Cfo
Phone
(502) 254-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

3101 Breckenridge LN Ste 4B
Louisville, KY 40220-2797

Mailing address

PO Box 437169
Louisville, KY 40253-7169

Other names 1

  • Kids Dentistree - Breckenridge Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kids Dentistree of Ky LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529884800000",
    "number": "1407341258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 437169",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402537169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 BRECKENRIDGE LN STE 4B",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402202797",
            "telephone_number": "502-451-1020",
            "fax_number": "502-451-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS DENTISTREE OF KY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-254-8500"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids Dentistree - Breckenridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

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

Verify at the official NPI Registry.