NPIMap

Organization Active NPI

Jeremy W. Allen DMD

  • General Practice Dentistry
  • London, KY
National Provider Identifier
1508162629
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8365 Issued in KY
Legal business name
JEREMY W. ALLEN DMD
Practice address
908 W 5TH St
Suite 114
London, KY 40741-2417
Phone
(606) 231-0594
NPI assigned
Feb 7, 2011
Last updated
Mar 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Authorized official

Name
Dr. Jeremy W Allen, DMDNPI 1386774057
Title
Dentist
Phone
(606) 231-0594

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 8365 KY
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 8365 KY Primary

Addresses

Primary practice location

908 W 5TH St
Suite 114
London, KY 40741-2417

Mailing address

908 W 5TH St
Suite 114
London, KY 40741-2417

Other identifiers 1

IdentifierTypeStateIssuer
60004306MedicaidKY

National Provider Directory

National Provider Directory

Locations

908 W 5th St
Ste 114
London, KY 40741
Phone (606) 231-0594

Practitioners & affiliated clinicians

Practitioners 1

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": "1297036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300752000000",
    "number": "1508162629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 W 5TH ST",
            "address_2": "SUITE 114",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407412417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 W 5TH ST",
            "address_2": "SUITE 114",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407412417",
            "telephone_number": "606-231-0594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMY W. ALLEN DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-07",
        "last_updated": "2011-03-22",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "606-231-0594",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "KY",
            "license": "8365",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "8365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60004306",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; 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.