Active NPI
Identity Dental Studio, PLLC
- Dental Clinic/Center
- Lexington, KY
National Provider Identifier
1760975650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Clinic/Center
- Legal business name
- IDENTITY DENTAL STUDIO, PLLC
- Doing business as
- iDS Smile Lab
- Practice address
- 541 Darby Creek Road
Ste 190
Lexington, KY 40509 - Phone
- (859) 287-2484
- Fax
- (859) 287-2484
- NPI assigned
- Jun 14, 2018
- Organization subpart
- Yes
- Parent organization
- IDENTITY DENTAL STUDIO, PLLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brandon M Stapleton, DMD, MSD
- Title
- Dentist/Owner
- Phone
- (859) 287-2484
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 9038 | KY | |
| Dental Clinic/Center | 261QD0000X | Primary |
Addresses
Primary practice location
541 Darby Creek Road
Ste 190
Lexington, KY 40509
Mailing address
541 Darby Creek Road
Ste 190
Lexington, KY 40509
Phone (859) 287-2484
Other names 1
- iDS Smile Lab
National Provider Directory
National Provider Directory- Part of
- Identity Dental Studio PLLC
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Lexington, KY
- NPI 1467292490
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528934400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1579132800000",
"number": "1760975650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "541 DARBY CREEK ROAD",
"address_2": "STE 190",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "40509",
"telephone_number": "859-287-2484",
"fax_number": "859-287-2484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "541 DARBY CREEK ROAD",
"address_2": "STE 190",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "40509",
"telephone_number": "859-287-2484",
"fax_number": "859-287-2484"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IDENTITY DENTAL STUDIO, PLLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "IDENTITY DENTAL STUDIO, PLLC",
"enumeration_date": "2018-06-14",
"last_updated": "2020-01-16",
"certification_date": "2020-01-16",
"status": "A",
"authorized_official_last_name": "STAPLETON",
"authorized_official_first_name": "BRANDON",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "DENTIST/OWNER",
"authorized_official_telephone_number": "859-287-2484",
"authorized_official_credential": "DMD, MSD"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Prosthodontics",
"state": "KY",
"license": "9038",
"primary": false
},
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "iDS Smile Lab",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.