Deiadre A Dery

Primary specialty

Dental AssistantTaxonomy code 126800000X

Practice address

962 1St Infatry Division Rd
Jordan Dental Clinic BLDG 2724
Fort Knox, KY 40121-5210

Phone

(502) 626-8301

Fax

(502) 626-8300

NPI assigned

Jun 20, 2016

Last updated

Jun 20, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1548610702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "398 192ND ARMORED TANK BN RD",
            "address_2": "USA DENTAC HEADQUARTERS BLDG 1022",
            "city": "FORT KNOX",
            "state": "KY",
            "postal_code": "401215116",
            "telephone_number": "502-624-6158",
            "fax_number": "502-624-2966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "962 1ST INFATRY DIVISION RD",
            "address_2": "JORDAN DENTAL CLINIC BLDG 2724",
            "city": "FORT KNOX",
            "state": "KY",
            "postal_code": "401215210",
            "telephone_number": "502-626-8301",
            "fax_number": "502-626-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERY",
        "first_name": "DEIADRE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurel Alexander Darhali, MSN-FNP
• Vickie Davidson, PHARMD
• Peter Dedina, MD
• William Frederick Dennis, EMT-B
• Nancy Diane Derosa, ARNP
• Rita M Devore, DDS
• Renee L Dodge, D.O.
• Momodoulamin S Drammeh, P.A.
• Douglas M Dudewicz, MD
• Lauri Lyn Duesler, OTR/L

• Dental Assistant in Fort Knox, KY
• Providers in Fort Knox, KY by specialty
• Dental Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.