NPIMap

Organization Active NPI

Ky Dental Professionals PSC

  • Dentist
  • Bowling Green, KY
National Provider Identifier
1538601943
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5637 Issued in KY
Legal business name
KY DENTAL PROFESSIONALS PSC
Practice address
1602 Westen St
Bowling Green, KY 42104-4156
Phone
(270) 781-1706
NPI assigned
Nov 16, 2016
Last updated
Aug 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Authorized official

Name
Pam Buscemi
Title
VP Business Operations
Phone
(615) 620-5990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5637 KY Primary

Addresses

Primary practice location

1602 Westen St
Bowling Green, KY 42104-4156

Mailing address

PO Box 306208
Nashville, TN 37230-6208
Phone (615) 620-5990

Other practice location 1

1836 Broadway St
Paducah, KY 42001-2708
Phone (270) 442-0256

Other names 1

  • Marquee Dental Partners Other name

National Provider Directory

National Provider Directory

Locations

1602 Westen St
Bowling Green, KY 42104
Phone (270) 781-1706

1836 Broadway St
Paducah, KY 42001
Phone (270) 442-0256

Practitioners & affiliated clinicians

Practitioners 5

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": "1479254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628553600000",
    "number": "1538601943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306208",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306208",
            "telephone_number": "615-620-5990",
            "fax_number": "888-702-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 WESTEN ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421044156",
            "telephone_number": "270-781-1706"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1836 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Paducah",
            "state": "KY",
            "postal_code": "420012708",
            "country_code": "US",
            "telephone_number": "270-442-0256",
            "fax_number": "270-442-8730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KY DENTAL PROFESSIONALS PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-16",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "BUSCEMI",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "VP BUSINESS OPERATIONS",
        "authorized_official_telephone_number": "615-620-5990"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "5637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marquee Dental Partners",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Marquee Dental Partners",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; 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.