Dixie Dental Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DIXIE DENTAL CENTER

Practice address

1480 Dixie Hwy
Louisville, KY 40210-1768

Phone

(502) 778-7414

NPI assigned

Jun 3, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Rod Fultz, DMD

Title

Dentist

Phone

(502) 778-7414

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Dixie Dental Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dixie Dental Center PSC

  • Dental Clinic/Center
  • Louisville, KY
  • NPI 1962552042
  NPD tax ID

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1679986160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 DIXIE HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402101768",
            "telephone_number": "502-778-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 DIXIE HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402101768",
            "telephone_number": "502-778-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIXIE DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "FULTZ",
        "authorized_official_first_name": "ROD",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "502-778-7414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61942355",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marissa Grace Dix, BS, RBT
• Nannette Bertram Dix, CSW
• Dixie Chiropractic & Rehabilitation, PSC
• Dixie Chiropractic Office, P.S.C.
• Dixie Dental and Dentures LLC
• Dixie Dental Center PSC
• Dixie Infusion Clinic, LLC
• Dixie Pharmacy LLC
• Dixie Primary Care LLC
• Ashwin Dixit, M.D.

• 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 Jun 3, 2014; 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.