Active NPI
Connie S Dunn, DMD
- Dentist
- Pendleton, KY
National Provider Identifier
1669696696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7215
- Practice address
- 1065 Pendleton Road
Pendleton, KY 40055 - Phone
- (502) 743-9190
- Fax
- (502) 743-0080
- NPI assigned
- Apr 12, 2007
- Last updated
- Jul 8, 2007
- 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 | 7215 | KY | Primary |
Addresses
Primary practice location
1065 Pendleton Road
Pendleton, KY 40055
Mailing address
PO Box 158
1065 Pendleton Road
Pendleton, KY 40055
Phone (502) 743-9190
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- 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 |
|---|---|---|---|---|
| I20160518001367 | KY | Order and Referring Only - Other (Physician) | 6002105814 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tyler W. Jury DMD, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Henry County Dentistry
- Dental Clinic/Center
- Pendleton, KY
- NPI 1487141552
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669696696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 158",
"address_2": "1065 PENDLETON ROAD",
"city": "PENDLETON",
"state": "KY",
"postal_code": "40055",
"telephone_number": "502-743-9190",
"fax_number": "502-743-0080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1065 PENDLETON ROAD",
"city": "PENDLETON",
"state": "KY",
"postal_code": "40055",
"telephone_number": "502-743-9190",
"fax_number": "502-743-0080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNN",
"first_name": "CONNIE",
"middle_name": "S",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "7215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pendleton, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.