NPIMap

Organization Active NPI

Pactee Dental PLLC

  • Dentist
  • Louisville, KY
National Provider Identifier
1639529720
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6006 Issued in KY
Legal business name
PACTEE DENTAL PLLC
Practice address
5417 Robbs LN
Louisville, KY 40219-4043
Phone
(502) 969-9897
Fax
(502) 969-0296
NPI assigned
Jun 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Authorized official

Name
Dr. Paul King, DMDNPI 1902898687
Title
Member
Phone
(502) 727-2636

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 6006 KY Primary

Addresses

Primary practice location

5417 Robbs LN
Louisville, KY 40219-4043

Mailing address

935 Willow Creek LN
Louisville, KY 40245-7001

National Provider Directory

National Provider Directory

Locations

5417 Robbs Ln
Louisville, KY 40219
Phone (502) 969-9897

Practitioners & affiliated clinicians

Practitioners 2

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": "1466380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1639529720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 WILLOW CREEK LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402457001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5417 ROBBS LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402194043",
            "telephone_number": "502-969-9897",
            "fax_number": "502-969-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACTEE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "502-727-2636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "KY",
            "license": "6006",
            "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 Jun 20, 2016; 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.