Pediatric Dentistry of Shelbyville

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

7601 Issued in KY

Legal business name

PEDIATRIC DENTISTRY OF SHELBYVILLE

Practice address

141 Stonecrest Rd
Shelbyville, KY 40065-8164

Phone

(502) 633-4441

Fax

(502) 633-4470

NPI assigned

Jul 21, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Amy E Raisor

Title

Office Manager

Phone

(502) 633-4441

Specialties & licenses 2

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kirby Chambers Hoetker, DMD

  • Pediatric Dentistry
  • Shelbyville, KY
  • NPI 1598767030
  NPD (past)
• Katrina Nicole Raneses, DMD

  • Dentist
  • Elizabethtown, KY
  • NPI 1437032000
  NPD (past)

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254960000000",
    "number": "1770748790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 STONECREST RD",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658164",
            "telephone_number": "502-633-4441",
            "fax_number": "502-633-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 STONECREST RD",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658164",
            "telephone_number": "502-633-4441",
            "fax_number": "502-633-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY OF SHELBYVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-21",
        "last_updated": "2009-10-08",
        "status": "A",
        "authorized_official_last_name": "RAISOR",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "502-633-4441",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "7277",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "7601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Patrick, OT
• Cindy S Payne, LPN
• Donald W Payne, MD
• Pdos Dre LLC
• Pediatric and Neonatal Practice
• Pediatric Products, LLC
• Pediatric Products, LLC
• Penny Pendleton
• Antolin Julian Perez, M.D.
• Anna Nicole Perlack, OT

• Pediatric Dentistry in Shelbyville, KY
• Providers in Shelbyville, KY by specialty
• Pediatric Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; 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.