Active NPI
Marissa Renee Emery, DMD
- Dentist
- Georgetown, KY
National Provider Identifier
1568086338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10898
- Practice address
- 450 Connector Rd # 200
Georgetown, KY 40324-9729 - Phone
- (865) 233-8739
- NPI assigned
- Jun 8, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10898 | KY | Primary |
| General Practice Dentistry | 1223G0001X | 11254 | TN |
Addresses
Primary practice location
450 Connector Rd # 200
Georgetown, KY 40324-9729
Mailing address
3792 Stolen Horse Trce
Lexington, KY 40509-2145
Phone (231) 855-2800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10898 | KY | MD | Dentist |
| 11254 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695254400000",
"number": "1568086338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3792 STOLEN HORSE TRCE",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405092145",
"telephone_number": "231-855-2800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 CONNECTOR RD # 200",
"city": "GEORGETOWN",
"state": "KY",
"postal_code": "403249729",
"telephone_number": "865-233-8739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMERY",
"first_name": "MARISSA",
"middle_name": "RENEE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-08",
"last_updated": "2023-09-21",
"certification_date": "2023-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "10898",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TN",
"license": "11254",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.