Derby City Pediatric Dentistry, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

DERBY CITY PEDIATRIC DENTISTRY, PLLC

Doing business as

Derby City Pediatric Dentistry

Practice address

2120 High Wickham PL Ste 103
Louisville, KY 40245-5903

Phone

(502) 254-6097

Fax

(502) 254-6098

NPI assigned

Feb 5, 2020

Last updated

Feb 5, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Korie Dunhoft Acord, DMDNPI 1063584936

Title

Owner, Pediatric Dentist

Phone

(502) 254-6097

Specialties & licenses 1

Addresses

Other names 1

• Derby City Pediatric Dentistry Doing business as

Locations

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.

• Korie Dunhoft Acord, DMD

  • Pediatric Dentistry
  • Louisville, KY
  • NPI 1063584936
  NPD (past) Authorized official

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1518599802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 HIGH WICKHAM PL STE 103",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402455903",
            "telephone_number": "502-254-6097",
            "fax_number": "502-254-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 HIGH WICKHAM PL STE 103",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402455903",
            "telephone_number": "502-254-6097",
            "fax_number": "502-254-6098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERBY CITY PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "ACORD",
        "authorized_official_first_name": "KORIE",
        "authorized_official_middle_name": "DUNHOFT",
        "authorized_official_title_or_position": "OWNER, PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "502-254-6097",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Derby City Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amber Zimmer Deptola, MD
• Anthony Deras
• Derby City Foot Doctors PLLC
• Derby City Hearing, Inc. (Zounds of Louisville)
• Derby City Medical Partners, LLC
• Derby City Rehab
• Derby City Taxicab LLC
• Derbytown Healthcare LLC
• Brian M Derhake, M.D.
• Shannon Derkson

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.