Marylou S Head, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4853 Issued in KY

Practice address

3225 Summit Square PL
Suite 150
Lexington, KY 40509-2636

Phone

(859) 269-5386

Fax

(859) 266-6846

NPI assigned

Aug 20, 2006

Last updated

Apr 27, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303862400000",
    "number": "1780799908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 SUMMIT SQUARE PL",
            "address_2": "SUITE 150",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092636",
            "telephone_number": "859-269-5386",
            "fax_number": "859-266-6846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 SUMMIT SQUARE PL",
            "address_2": "SUITE 150",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092636",
            "telephone_number": "859-269-5386",
            "fax_number": "859-266-6846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAD",
        "first_name": "MARYLOU",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2011-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "4853",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "4853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45003753",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60048535",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• HC Systems, LLC (Coastal Biotech)
• HDM Pharmacy, LLC
• Head and Heart Healing, LLC
• Benjamin Michael Head
• Jackson Jeremy Head
• Walter Weller Head, CRNA
• Benjamin Landers Headley, MD
• Jeffrey Scott Healander, OTR/L
• Healing Grace LLC
• Healing in Motion, PLLC

• General Practice Dentistry in Lexington, KY
• Providers in Lexington, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; 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.