Individual provider Active NPI

Beverly A Largent, D.M.D.

  • Pediatric Dentistry
  • Paducah, KY
National Provider Identifier
1700946647
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
5466 Issued in KY
Practice address
3008 Oregon St
Paducah, KY 42001-5651
Phone
(270) 554-5437
Fax
(270) 554-5236
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 5466 KY Primary

Addresses

Primary practice location

3008 Oregon St
Paducah, KY 42001-5651

Mailing address

3008 Oregon St
Paducah, KY 42001-5651
Phone (270) 554-5437

Other identifiers 1

IdentifierTypeStateIssuer
60054665MedicaidKY

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5466KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Beverly a Largent, D.M.D. Pediatric Dentistry 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1700946647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3008 OREGON ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420015651",
            "telephone_number": "270-554-5437",
            "fax_number": "270-554-5236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3008 OREGON ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420015651",
            "telephone_number": "270-554-5437",
            "fax_number": "270-554-5236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARGENT",
        "first_name": "BEVERLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "5466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60054665",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; 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.