Individual provider Active NPI

Trent Nelson, D.M.D.

  • General Practice Dentistry
  • Paducah, KY
National Provider Identifier
1780779801
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7500 Issued in KY
Practice address
657 Lone Oak Rd
Suite 5
Paducah, KY 42003-4547
Phone
(270) 442-5071
Fax
(270) 442-5067
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7500 KY Primary

Addresses

Primary practice location

657 Lone Oak Rd
Suite 5
Paducah, KY 42003-4547

Mailing address

657 Lone Oak Rd
Suite 5
Paducah, KY 42003-4547
Phone (270) 442-5071

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
7500KYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Trent M. Nelson, D.M.D. P.S.C. General Practice 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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780779801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 LONE OAK RD",
            "address_2": "SUITE 5",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420034547",
            "telephone_number": "270-442-5071",
            "fax_number": "270-442-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 LONE OAK RD",
            "address_2": "SUITE 5",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420034547",
            "telephone_number": "270-442-5071",
            "fax_number": "270-442-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TRENT",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "7500",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 8, 2007; 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.