Active NPI
December Dawn Parker, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Louisville, KY
National Provider Identifier
1710246079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- NOT YET OBTAINED
- Practice address
- 501 S Preston St
Louisville, KY 40202-1701 - Phone
- (502) 852-0002
- NPI assigned
- May 8, 2012
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | NOT YET OBTAINED | KY | Primary |
Addresses
Primary practice location
501 S Preston St
Louisville, KY 40202-1701
Mailing address
501 S Preston St
Louisville, KY 40202-1701
Phone (502) 852-0002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- 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 |
|---|---|---|---|---|
| I20160824000235 | IN | Order and Referring Only - Other (Physician) | 7113212556 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NOT YET OBTAINED | KY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336435200000",
"number": "1710246079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 S PRESTON ST",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021701",
"telephone_number": "502-852-0002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 S PRESTON ST",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021701",
"telephone_number": "502-852-0002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER",
"first_name": "DECEMBER",
"middle_name": "DAWN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-08",
"last_updated": "2012-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "KY",
"license": "NOT YET OBTAINED",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; 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.