Individual provider Active NPI

John Andrew Houston, DMD, PHD, MSD

  • Periodontics
  • Louisville, KY
National Provider Identifier
1447789029
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
9997 Issued in KY
Practice address
5141 Dixie Hwy Ste 102
Louisville, KY 40216-1765
Phone
(502) 448-1546
Fax
(502) 448-9979
NPI assigned
Jun 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 9997 KY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

5141 Dixie Hwy Ste 102
Louisville, KY 40216-1765

Mailing address

5141 Dixie Hwy Ste 102
Louisville, KY 40216-1765
Phone (502) 448-1546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
9997KYMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1447789029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5141 DIXIE HWY STE 102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402161765",
            "telephone_number": "502-448-1546",
            "fax_number": "502-448-9979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5141 DIXIE HWY STE 102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402161765",
            "telephone_number": "502-448-1546",
            "fax_number": "502-448-9979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSTON",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DMD, PHD, MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "KY",
            "license": "9997",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.