Organization Active NPI

Justice Dental Blazer PLLC

  • General Practice Dentistry
  • Lexington, KY
National Provider Identifier
1568006146
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JUSTICE DENTAL BLAZER PLLC
Practice address
3285 Blazer Pkwy Ste 200
Lexington, KY 40509-2119
Phone
(859) 543-0700
Fax
(859) 543-1078
NPI assigned
Nov 6, 2019
Last updated
Jul 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Authorized official

Name
Mrs. Laura Lynn Sisler
Title
Insurance Coordinator
Phone
(859) 543-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

3285 Blazer Pkwy Ste 200
Lexington, KY 40509-2119

Mailing address

3285 Blazer Pkwy Ste 200
Lexington, KY 40509-2119
Phone (859) 543-0700

National Provider Directory

National Provider Directory

Locations

3285 Blazer Pkwy
Ste 200
Lexington, KY 40509
Phone (859) 543-0700

NPI Registry JSON

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1568006146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3285 BLAZER PKWY STE 200",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092119",
            "telephone_number": "859-543-0700",
            "fax_number": "859-543-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3285 BLAZER PKWY STE 200",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092119",
            "telephone_number": "859-543-0700",
            "fax_number": "859-543-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTICE DENTAL BLAZER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-06",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "SISLER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "859-543-0700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.