Individual provider Active NPI

Robert E Kovarik, DMD

  • General Practice Dentistry
  • Lexington, KY
National Provider Identifier
1669570537
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6592 Issued in KY
Practice address
800 Rose St RM D104
University of Kentucky College of Dentistry
Lexington, KY 40536-0297
Phone
(859) 323-5831
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6592 KY
General Practice Dentistry 1223G0001X 6592 KY Primary

Addresses

Primary practice location

800 Rose St RM D104
University of Kentucky College of Dentistry
Lexington, KY 40536-0297

Mailing address

800 Rose St RM D104
University of Kentucky College of Dentistry
Lexington, KY 40536-0297
Phone (859) 323-5831

Other identifiers 1

IdentifierTypeStateIssuer
60065927MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421366400000",
    "number": "1669570537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ROSE ST RM D104",
            "address_2": "UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360297",
            "telephone_number": "859-323-5831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE ST RM D104",
            "address_2": "UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360297",
            "telephone_number": "859-323-5831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVARIK",
        "first_name": "ROBERT",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2015-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "6592",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "6592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60065927",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; 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.