Beaumont Kids Dre LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

BEAUMONT KIDS DRE LLC

Practice address

3141 Beaumont Centre Cir Ste 100
Lexington, KY 40513-1934

Phone

(859) 223-4888

NPI assigned

Nov 6, 2023

Organization subpart

No

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

Authorized official

Name

Elizabeth Davis

Title

Director of Revenue

Phone

(859) 533-1109

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jackie L Banahan, D.M.D.

  • Pediatric Dentistry
  • Lexington, KY
  • NPI 1093866154
  NPD (past)

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1487427019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SPRUCE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405072109",
            "telephone_number": "859-533-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3141 BEAUMONT CENTRE CIR STE 100",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131934",
            "telephone_number": "859-223-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUMONT KIDS DRE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE",
        "authorized_official_telephone_number": "859-533-1109"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alanna R Beaudette, CRNA
• Beaumont Behavioral Health PSC
• Beaumont Dental Associates, PLLC
• Beaumont Family Dentistry at Leestown
• Beaumont Integrated Medicine PSC
• Beaumont Psychiatry PLLC
• Heidi Beavan, APRN
• Emily Beaven, PA
• Lauren Swartzbaugh Beaven, MD
• Nicole Cutshaw Beaven, CRNA

• Pediatric Dentistry in Lexington, KY
• Providers in Lexington, KY by specialty
• Pediatric Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.