Organization Active NPI

Jeffrey L. Edwards, DMD PSC

  • Dentist
  • Lexington, KY
National Provider Identifier
1417119306
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5681 Issued in KY
Legal business name
JEFFREY L. EDWARDS, DMD PSC
Practice address
2134 Nicholasville Rd
#15
Lexington, KY 40503-2521
Phone
(859) 278-0427
Fax
(859) 278-8873
NPI assigned
Jul 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Authorized official

Name
Dr. Jeffrey L Edwards, DMDNPI 1407996259
Title
President
Phone
(859) 278-0427

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 5681 KY Primary

Addresses

Primary practice location

2134 Nicholasville Rd
#15
Lexington, KY 40503-2521

Mailing address

2134 Nicholasville Rd
#15
Lexington, KY 40503-2521
Phone (859) 278-0427

Other identifiers 1

IdentifierTypeStateIssuer
60056819MedicaidKY

National Provider Directory

National Provider Directory

Locations

2134 Nicholasville Rd
Ste 15
Lexington, KY 40503
Phone (859) 278-0427

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1417119306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2134 NICHOLASVILLE RD",
            "address_2": "#15",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405032521",
            "telephone_number": "859-278-0427",
            "fax_number": "859-278-8873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2134 NICHOLASVILLE RD",
            "address_2": "#15",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405032521",
            "telephone_number": "859-278-0427",
            "fax_number": "859-278-8873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY L. EDWARDS, DMD PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-01",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-278-0427",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "KY",
            "license": "5681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60056819",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; 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.