L'Cris Amaru Real Weathers, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11433 Issued in KY

Practice address

1000 E John Rowan Blvd Ste 101
Bardstown, KY 40004-2060

Phone

(502) 348-2589

NPI assigned

Jul 3, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hunt Family Dentistry

  • Dental Clinic/Center
  • Bardstown, KY
  • NPI 1073135018
  NPD
• Proctor Family Dental Radcliff

  • Dental Clinic/Center
  • Radcliff, KY
  • NPI 1013891225
  NPD
• West End Family Dental Clinic LLC

  • General Practice Dentistry
  • Louisville, KY
  • NPI 1053734541
  NPD (past)

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

{
    "created_epoch": "1751500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1467342345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W LINCOLN TRAIL BLVD STE 25",
            "city": "RADCLIFF",
            "state": "KY",
            "postal_code": "401603301",
            "telephone_number": "502-772-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E JOHN ROWAN BLVD STE 101",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400042060",
            "telephone_number": "502-348-2589"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 W Lincoln Trail Blvd Ste 25",
            "address_purpose": "LOCATION",
            "city": "Radcliff",
            "state": "KY",
            "postal_code": "401603301",
            "country_code": "US",
            "telephone_number": "270-390-0006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEATHERS",
        "first_name": "L'CRIS",
        "middle_name": "AMARU REAL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-03",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "11433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia A Walston, WHNP
• Michael Walton, D.M.D.
• Norman Walton Jr., RPH
• Stephanie Wagoner Walton, OT/L
• Kristi Watson, M.S LCADC, CCTP, BIP
• Ciara Weir, CADC
• Andrew Wickham Werner, DMD
• Timothy M West, PA-C
• Kimberly Wheatley, RPH
• Charity Wickliffe

• General Practice Dentistry in Bardstown, KY
• Providers in Bardstown, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; 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.