Nadia Maria Pendleton, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

10955 Issued in KY

Practice address

10640 Dixie Hwy
Louisville, KY 40272-4350

Phone

(812) 972-8843

NPI assigned

Mar 27, 2023

Last updated

May 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Mortenson Family Dental Center-Valley Station

  • Dental Clinic/Center
  • Louisville, KY
  • NPI 1427376490
  NPD (past)

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1407550452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 BARRALLTON HILL RD",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401655619",
            "telephone_number": "812-972-8843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10640 DIXIE HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402724350",
            "telephone_number": "812-972-8843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDLETON",
        "first_name": "NADIA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "10955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Nicola Pendergrast
• Amber L Pendleton, MD
• Dawn W Pendleton, LMFT
• Kayla Pendleton
• Michael Eli Pendleton, MD
• Porshia Pendleton, MSOT, OTR/L
• Terrell Lee Pendleton, DMD
• Amberly S Pendley
• Lynn M Pendley, M.S., R.D., L.D.
• Chaisak Pengvanich, M.D.

• Dentist in Louisville, KY
• Providers in Louisville, KY by specialty
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.