NPIMap

Organization Active NPI

Elkhorn Dental PSC

  • Dental Clinic/Center
  • Elkhorn City, KY
National Provider Identifier
1467010629
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
ELKHORN DENTAL PSC
Practice address
155 E Main St
Elkhorn City, KY 41522-9043
Phone
(606) 754-0155
Fax
(606) 754-0151
NPI assigned
Jun 3, 2019
Last updated
Dec 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Authorized official

Name
Dr. James D Justice, DMDNPI 1396891347
Title
Owner/President
Phone
(606) 754-0155

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

155 E Main St
Elkhorn City, KY 41522-9043

Mailing address

PO Box 1500
Elkhorn City, KY 41522-1500
Phone (606) 754-0155

Other practice location 1

807 Park Ave NE
Norton, VA 24273-1009
Phone (276) 679-6030

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608076800000",
    "number": "1467010629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1500",
            "city": "ELKHORN CITY",
            "state": "KY",
            "postal_code": "415221500",
            "telephone_number": "606-754-0155",
            "fax_number": "606-754-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 E MAIN ST",
            "city": "ELKHORN CITY",
            "state": "KY",
            "postal_code": "415229043",
            "telephone_number": "606-754-0155",
            "fax_number": "606-754-0151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "807 Park Ave NE",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "242731009",
            "country_code": "US",
            "telephone_number": "276-679-6030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELKHORN DENTAL PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-03",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A",
        "authorized_official_last_name": "JUSTICE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "606-754-0155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn City, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.