Active NPI
Shawnee Dental, PLLC.
- General Practice Dentistry
- Louisville, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- SHAWNEE DENTAL, PLLC.
- Practice address
- 222 Amy Ave
Louisville, KY 40212-2522 - Phone
- (502) 774-2400
- Fax
- (502) 772-3456
- NPI assigned
- Aug 29, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Thomas E McLean, D.M.D.
- Title
- Owner
- Phone
- (502) 774-2400
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
222 Amy Ave
Louisville, KY 40212-2522
Mailing address
222 Amy Ave
Louisville, KY 40212-2522
Phone (502) 774-2400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61901344 | Medicaid | KY |
National Provider Directory
National Provider Directory- Tax ID family
- Shawnee Dental PLLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Dentist
- Louisville, KY
- NPI 1316935661
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Louisville, KY
- NPI 1013905264
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188345600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1188345600000",
"number": "1780878108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 AMY AVE",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402122522",
"telephone_number": "502-774-2400",
"fax_number": "502-772-3456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 AMY AVE",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402122522",
"telephone_number": "502-774-2400",
"fax_number": "502-772-3456"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHAWNEE DENTAL, PLLC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-29",
"last_updated": "2007-08-29",
"status": "A",
"authorized_official_last_name": "MCLEAN",
"authorized_official_first_name": "THOMAS",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "502-774-2400",
"authorized_official_credential": "D.M.D."
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "61901344",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.