Active NPI
Alicia Maria Tenrrero-Villalon, DMD
- Dentist
- Louisville, KY
National Provider Identifier
1598327371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10338
- Practice address
- 4814 Outer Loop
Louisville, KY 40219-3302 - Phone
- (502) 473-6974
- NPI assigned
- Jul 2, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10338 | KY | Primary |
Addresses
Primary practice location
4814 Outer Loop
Louisville, KY 40219-3302
Mailing address
5000 Woodhill LN
Louisville, KY 40219-2867
Phone (502) 295-1908
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230824001057 | IN | Order and Referring Only - Dentist | 9537522586 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10338 | KY | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Villalon Dental PLLC | Current | Accepting new patients | |
| Dental Services of Kentucky, PSC | Dentist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Louisville, KY
- NPI 1205783909
-
- Dentist
- Louisville, KY
- NPI 1639562473
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562025600000",
"number": "1598327371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 WOODHILL LN",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402192867",
"telephone_number": "502-295-1908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4814 OUTER LOOP",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402193302",
"telephone_number": "502-473-6974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TENRRERO-VILLALON",
"first_name": "ALICIA",
"middle_name": "MARIA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-02",
"last_updated": "2019-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "10338",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.