Active NPI
Gwinn A. K. Vonnahme, DMD
- General Practice Dentistry
- Crestwood, KY
National Provider Identifier
1780881649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8525
- Practice address
- 5998 Pleasant Colony CT. Suite 23
Crestwood, KY 40014 - Phone
- (502) 890-2035
- Fax
- (502) 890-2037
- NPI assigned
- Jul 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8525 | KY | Primary |
Addresses
Primary practice location
5998 Pleasant Colony CT. Suite 23
Crestwood, KY 40014
Mailing address
5998 Pleasant Colony CT. Suite 23
Crestwood, KY 40014
Phone (502) 890-2035
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160519001611 | KY | Order and Referring Only - Oral Surgery | 3173812872 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8525 | KY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510617600000",
"number": "1780881649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5998 PLEASANT COLONY CT. SUITE 23",
"city": "CRESTWOOD",
"state": "KY",
"postal_code": "40014",
"telephone_number": "502-890-2035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5998 PLEASANT COLONY CT. SUITE 23",
"city": "CRESTWOOD",
"state": "KY",
"postal_code": "40014",
"telephone_number": "502-890-2035",
"fax_number": "502-890-2037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VONNAHME",
"first_name": "GWINN",
"middle_name": "A. K.",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-02",
"last_updated": "2017-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "8525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crestwood, KY
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- Winifred Mallory Turner
- Jennifer Vale, PT
- Kristen L Vanwagner, OTR/L
- Brittany Vittitow, PHARMD
- Stephanie Vontrapp
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.