NPIMap

Organization Active NPI

Edp of Kentucky PC

  • Dental Clinic/Center
  • Henderson, KY
National Provider Identifier
1508367665
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
EDP OF KENTUCKY PC
Practice address
342 Starlite Dr
Henderson, KY 42420-6102
Phone
(270) 826-1414
NPI assigned
Feb 23, 2018
Organization subpart
Yes
Parent organization
EDP OF KENTUCKY PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Authorized official

Name
Roseanne Brunenkant
Title
Director of Integrations
Phone
(312) 937-3619

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

342 Starlite Dr
Henderson, KY 42420-6102

Mailing address

141 W Jackson Blvd Ste 210
Chicago, IL 60604-3048
Phone (312) 800-1270

Other practice location 1

3017 Poplar Level Rd
Louisville, KY 40217-2300
Phone (502) 451-2005

Other practice location 2

3707 Chamberlain Ln Ste 103
Louisville, KY 40241-2091
Phone (502) 412-2222

Other practice location 3

8172 Mall Rd
Florence, KY 41042-1499
Phone (859) 525-7775

National Provider Directory

National Provider Directory
Part of
Edp of Kentucky PC

Locations

1 E Wacker Dr
Ste 2520
Chicago, IL 60601

342 Starlite Dr
Henderson, KY 42420
Phone (270) 826-1414

3707 Chamberlain Ln
Ste 103
Louisville, KY 40241
Phone (502) 412-2222

3017 Poplar Level Rd
Louisville, KY 40217
Phone (502) 451-2005

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1519344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568592000000",
    "number": "1508367665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 W JACKSON BLVD STE 210",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043048",
            "telephone_number": "312-800-1270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 STARLITE DR",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424206102",
            "telephone_number": "270-826-1414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3017 Poplar Level Rd",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402172300",
            "country_code": "US",
            "telephone_number": "502-451-2005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3707 Chamberlain Ln Ste 103",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402412091",
            "country_code": "US",
            "telephone_number": "502-412-2222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8172 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "KY",
            "postal_code": "410421499",
            "country_code": "US",
            "telephone_number": "859-525-7775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EDP OF KENTUCKY PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EDP OF KENTUCKY PC",
        "enumeration_date": "2018-02-23",
        "last_updated": "2019-09-16",
        "status": "A",
        "authorized_official_last_name": "BRUNENKANT",
        "authorized_official_first_name": "ROSEANNE",
        "authorized_official_title_or_position": "DIRECTOR OF INTEGRATIONS",
        "authorized_official_telephone_number": "312-937-3619"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.