Kids Dentistry-Jefferson Mall,PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

KIDS DENTISTRY-JEFFERSON MALL,PLLC

Practice address

5100 Outer Loop
Suite C
Louisville, KY 40219-4056

Phone

(502) 969-9266

Fax

(502) 254-6054

NPI assigned

Feb 4, 2008

Organization subpart

No

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

Authorized official

Name

Steve James

Title

Coo

Phone

(502) 254-8504

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295395200000",
    "number": "1639357502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 437169",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402537169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 OUTER LOOP",
            "address_2": "SUITE C",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402194056",
            "telephone_number": "502-969-9266",
            "fax_number": "502-254-6054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS DENTISTRY-JEFFERSON MALL,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-04",
        "last_updated": "2011-01-19",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "502-254-8504"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kids Dentistree of Ky LLC
• Kids Dentistree of Ky, LLC
• Kids Dentistree of Ky, LLC
• Kids Dentistree of Ky, LLC
• Kids Dentistry- Dixie Highway PLLC
• Kids Without Limits LLC
• Kidvance Therapy
• Blaire Kidwell, RBT
• Joshua Charles Kidwell, APRN
• Donna Sue Kiefer, OTR

• Dental Clinic/Center in Louisville, KY
• Providers in Louisville, KY by specialty
• Dental Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; 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.