NPIMap

Organization Active NPI

Dental Health Professionals of Kentucky, P.S.C.

Doing business as Dental Care at Triple Crown

  • Dentist
  • Walton, KY
National Provider Identifier
1407744089
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DENTAL HEALTH PROFESSIONALS OF KENTUCKY, P.S.C.
Doing business as
Dental Care at Triple Crown
Practice address
450 Richwood Rd Ste 305
Walton, KY 41094-7440
Phone
(859) 419-0768
Fax
(859) 419-0769
NPI assigned
Jun 24, 2025
Last updated
Jun 24, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL HEALTH PROFESSIONALS OF KENTUCKY, P.S.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Authorized official

Name
Cemyira McDougal
Title
Credentialing Coordinator
Phone
(217) 764-8609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

450 Richwood Rd Ste 305
Walton, KY 41094-7440

Mailing address

450 Richwood Rd Ste 305
Walton, KY 41094-7440
Phone (859) 419-0768

Other names 1

  • Dental Care at Triple Crown Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Health Professionals of Kentucky PSC19 organizations share this tax ID, including this one
Part of
Dental Health Professionals of Kentucky PSC

Other organizations with this tax ID 18

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

View all 18

Locations

450 Richwood Rd
Ste 305
Walton, KY 41094
Phone (859) 419-0768

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1750723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1407744089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 RICHWOOD RD STE 305",
            "city": "WALTON",
            "state": "KY",
            "postal_code": "410947440",
            "telephone_number": "859-419-0768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 RICHWOOD RD STE 305",
            "city": "WALTON",
            "state": "KY",
            "postal_code": "410947440",
            "telephone_number": "859-419-0768",
            "fax_number": "859-419-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL HEALTH PROFESSIONALS OF KENTUCKY, P.S.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL HEALTH PROFESSIONALS OF KENTUCKY, P.S.C.",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-04",
        "status": "A",
        "authorized_official_last_name": "MCDOUGAL",
        "authorized_official_first_name": "CEMYIRA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-764-8609"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care at Triple Crown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walton, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.