Individual provider Active NPI

Sydney Cullop Salow

  • Dentist
  • Ashland, KY
National Provider Identifier
1407438856
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10588 Issued in KY
Practice address
500 Winchester Ave Ste 420
Ashland, KY 41101-7367
Phone
(606) 324-0800
NPI assigned
Apr 26, 2021
Last updated
Jun 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4532 WV
Dentist 122300000X 10588 KY Primary

Addresses

Primary practice location

500 Winchester Ave Ste 420
Ashland, KY 41101-7367

Mailing address

4010 Grandview Dr
Ashland, KY 41101-6259
Phone (606) 547-6100

Other practice location 1

29 Tanyard Station Dr
Barboursville, WV 25504-1168
Phone (304) 948-2006

Other names 1

  • Sydney Nicole Cullop Former 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
I20240524000067 KY Order and Referring Only - DentistPractitioner - Dentist 5799127551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10588KYMDDentist
4532WVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Joel M Cost DDS PLLC General Practice PastSince Jun 6, 2021 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.

NPI Registry JSON

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1407438856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 GRANDVIEW DR",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411016259",
            "telephone_number": "606-547-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WINCHESTER AVE STE 420",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411017367",
            "telephone_number": "606-324-0800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29 Tanyard Station Dr",
            "address_purpose": "LOCATION",
            "city": "Barboursville",
            "state": "WV",
            "postal_code": "255041168",
            "country_code": "US",
            "telephone_number": "304-948-2006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALOW",
        "first_name": "SYDNEY",
        "middle_name": "CULLOP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-26",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "4532",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "10588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SYDNEY",
            "last_name": "CULLOP",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ashland, KY

Sources for this page

Verify at the official NPI Registry.