Individual provider Active NPI

Eric Neel Nunnally, D.M.D.

  • General Practice Dentistry
  • Louisville, KY
National Provider Identifier
1437596954
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9305 Issued in KY
Practice address
2950 Terra Crossing Blvd Ste B
Louisville, KY 40245-5350
Phone
(502) 315-1152
NPI assigned
May 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9305 KY Primary

Addresses

Primary practice location

2950 Terra Crossing Blvd Ste B
Louisville, KY 40245-5350

Mailing address

2950 Terra Crossing Blvd Ste B
Louisville, KY 40245-5350
Phone (502) 315-1152

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
I20160111002218 KY Order and Referring Only - DentistPractitioner - Dentist 4880996651

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9305KYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Triple Crown Dentistry General Practice Past 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": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1437596954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 TERRA CROSSING BLVD STE B",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402455350",
            "telephone_number": "502-315-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 TERRA CROSSING BLVD STE B",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402455350",
            "telephone_number": "502-315-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNNALLY",
        "first_name": "ERIC",
        "middle_name": "NEEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-23",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.