Eduardo Antunes Bortoluzzi, DDS, MSC, PHD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

10563 Issued in KY

Practice address

501 S Preston St
Louisville, KY 40202-1701

Phone

(502) 852-5096

NPI assigned

Feb 9, 2022

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 9, 2022.

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1457005332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6324 MEETING ST APT 446",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400598718",
            "telephone_number": "502-701-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S PRESTON ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021701",
            "telephone_number": "502-852-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTUNES BORTOLUZZI",
        "first_name": "EDUARDO",
        "credential": "DDS, MSC, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "KY",
            "license": "10563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://louisville.edu/dentistry/",
            "affiliation": "N",
            "endpointDescription": "School of Dentistry",
            "address_1": "501 S Preston St",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Louisville, KY
• Endodontics in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.