David Emory Willey, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4847 Issued in KY

Practice address

4213 N Church Way
Louisville, KY 40207-3926

Phone

(502) 893-5454

Fax

(502) 894-8886

NPI assigned

Aug 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407960040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4213 N CHURCH WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073926",
            "telephone_number": "502-893-5454",
            "fax_number": "502-894-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4213 N CHURCH WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073926",
            "telephone_number": "502-893-5454",
            "fax_number": "502-894-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLEY",
        "first_name": "DAVID",
        "middle_name": "EMORY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "4847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Louise Willett
• Kari Lynn Willett, MA APA, BEHAVIOR SPC
• Olga A Willett, MD
• Renee Summers Willett, RPH
• Caroline S Willette, M.D.
• William a. Phillips DMD, PSC
• William D Newman DMD PLLC
• William E Moss PSC
• William H Haney MD PLLC Ultimate MD
• William P Owen MD PSC

• General Practice Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.