Cane Run Smile Center, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5214 Issued in KY

Legal business name

CANE RUN SMILE CENTER, INC.

Doing business as

FALLS CITY FAMILY DENTISTRY

Practice address

3050 W Broadway
Louisville, KY 40211-1475

Phone

(502) 778-2631

Fax

(502) 776-3454

NPI assigned

Jan 24, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Susie J. Riley, DMD

Title

Owner

Phone

(502) 778-2631

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• FALLS CITY FAMILY DENTISTRY Doing business as

Locations

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649325457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111475",
            "telephone_number": "502-778-2631",
            "fax_number": "502-776-3454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111475",
            "telephone_number": "502-778-2631",
            "fax_number": "502-776-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANE RUN SMILE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "SUSIE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-778-2631",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "5214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61942785",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID SUBCONTRACTOR #",
            "identifier": "168938",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FALLS CITY FAMILY DENTISTRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sara Brooke Canchola, APRN
• Adriana Carolina Candelaria Jimenez
• Ismael Candelario Fernandez
• Cane Run Chiropractic Center, PLLC
• Cane Run Chiropractic, PSC
• Cane Run Smile Center, Inc.
• Ali Canen
• Gabrielle Caniglia, PMHNP-BC
• Amber Cann, PHARMD, MBA
• Jamie L Cannady, NP

• General Practice Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.