Active NPI
Kentucky Dental Professionals, PSC
- General Practice Dentistry
- Henderson, KY
National Provider Identifier
1578871877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- KENTUCKY DENTAL PROFESSIONALS, PSC
- Practice address
- 616 Barrett Blvd
Henderson, KY 42420-2620 - Phone
- (270) 827-4534
- Fax
- (270) 827-4503
- NPI assigned
- Sep 21, 2010
- Organization subpart
- Yes
- Parent organization
- KENTUCKY DENTAL PROFESSIONALS, PSC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Pam Hardiek
- Title
- Insurance/Credentialing
- Phone
- (270) 827-4534
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
616 Barrett Blvd
Henderson, KY 42420-2620
Mailing address
616 Barrett Blvd
Henderson, KY 42420-2620
Phone (270) 827-4534
Other names 1
- Northwest Kentucky Dental Centre
National Provider Directory
National Provider Directory- Tax ID family
- Kentucky Dental Professionals PSC
- Part of
- Kentucky Dental Professionals PSC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Practice Dentistry
- Crescent Springs, KY
- NPI 1811162357
-
- Dentist
- Lexington, KY
- NPI 1013160522
Locations
616 Barret Blvd
Henderson, KY 42420
Phone (270) 827-4534
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285027200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1285027200000",
"number": "1578871877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "616 BARRETT BLVD",
"city": "HENDERSON",
"state": "KY",
"postal_code": "424202620",
"telephone_number": "270-827-4534",
"fax_number": "270-827-4503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "616 BARRETT BLVD",
"city": "HENDERSON",
"state": "KY",
"postal_code": "424202620",
"telephone_number": "270-827-4534",
"fax_number": "270-827-4503"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KENTUCKY DENTAL PROFESSIONALS, PSC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "KENTUCKY DENTAL PROFESSIONALS, PSC",
"enumeration_date": "2010-09-21",
"last_updated": "2010-09-21",
"status": "A",
"authorized_official_last_name": "HARDIEK",
"authorized_official_first_name": "PAM",
"authorized_official_title_or_position": "INSURANCE/CREDENTIALING",
"authorized_official_telephone_number": "270-827-4534"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Northwest Kentucky Dental Centre",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Henderson, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.