Organization Active NPI

Strull & Strull, PSC

  • Oral and Maxillofacial Surgery (Dentist)
  • Louisville, KY
National Provider Identifier
1508986951
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
STRULL & STRULL, PSC
Practice address
4122 Shelbyville Rd
Suite a
Louisville, KY 40207-3242
Phone
(502) 896-4401
Fax
(502) 893-4930
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Authorized official

Name
Dr. Gregory Evan Strull, DMDNPI 1336232826
Title
Oral Surgeon
Phone
(502) 896-4401

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
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

4122 Shelbyville Rd
Suite a
Louisville, KY 40207-3242

Mailing address

4122 Shelbyville Rd Ste a
Louisville, KY 40207-3212
Phone (502) 896-4401

Other identifiers 1

IdentifierTypeStateIssuer
100001530AMedicaidIN

National Provider Directory

National Provider Directory

Locations

4122 Shelbyville Rd
Ste A
Louisville, KY 40207
Phone (502) 805-3074

Practitioners & affiliated clinicians

Practitioners 2

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": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236124800000",
    "number": "1508986951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4122 SHELBYVILLE RD STE A",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073212",
            "telephone_number": "502-896-4401",
            "fax_number": "502-893-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4122 SHELBYVILLE RD",
            "address_2": "SUITE A",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073242",
            "telephone_number": "502-896-4401",
            "fax_number": "502-893-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRULL & STRULL, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2009-03-04",
        "status": "A",
        "authorized_official_last_name": "STRULL",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "EVAN",
        "authorized_official_title_or_position": "ORAL SURGEON",
        "authorized_official_telephone_number": "502-896-4401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001530A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; 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.