Active NPI
Andrew Benjamin Paez, DMD
- General Practice Dentistry
- Florence, KY
National Provider Identifier
1760112346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 10798
- Practice address
- 7901 Mall Rd
Florence, KY 41042-1496 - Phone
- (551) 212-0062
- NPI assigned
- Jun 15, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 10798 | KY | Primary |
Addresses
Primary practice location
7901 Mall Rd
Florence, KY 41042-1496
Mailing address
102 E Madison St
La Grange, KY 40031-1424
Phone (561) 632-5553
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10798 | KY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664755200000",
"number": "1760112346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 E MADISON ST",
"city": "LA GRANGE",
"state": "KY",
"postal_code": "400311424",
"telephone_number": "561-632-5553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7901 MALL RD",
"city": "FLORENCE",
"state": "KY",
"postal_code": "410421496",
"telephone_number": "551-212-0062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAEZ",
"first_name": "ANDREW",
"middle_name": "BENJAMIN",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-15",
"last_updated": "2022-10-03",
"certification_date": "2022-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "10798",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florence, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.