Pediatric Dentistry of Georgetown, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

7468 Issued in KY

Legal business name

PEDIATRIC DENTISTRY OF GEORGETOWN, PLLC

Practice address

101 Darby Dr Ste 101
Georgetown, KY 40324-8715

Phone

(502) 867-0451

Fax

(502) 867-0458

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Christopher A Cotterill, D.M.D.

Title

Owner

Phone

(502) 867-0451

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1447331509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DARBY DR STE 101",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403248715",
            "telephone_number": "502-867-0451",
            "fax_number": "502-867-0458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DARBY DR STE 101",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403248715",
            "telephone_number": "502-867-0451",
            "fax_number": "502-867-0458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY OF GEORGETOWN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "COTTERILL",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-867-0451",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "754",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "KY",
            "license": "7468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60003530",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• P&N Behavioral Health
• Christen Guffey Page, PHD, CCC-SLP
• Natasha Painter, LPCC
• Kelli Parks, RPH
• Paula K Lenox DMD PSC (Advanced Dental Care of Central KY)
• Lindsay Perry, ATC
• Mia G Perry, LCSW
• Peters Chiropractic LLC (Landmark Chiropractic)
• Yolanda Alicia Petocchi, DC
• Brittany Lauren Petty, MSN, APRN, FNP-C

• Dental Clinic/Center in Georgetown, KY
• Providers in Georgetown, KY by specialty
• Dental Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.