Active NPI
Janeice Aisha Wooten-Kerr, DDS
- General Practice Dentistry
- Louisville, KY
National Provider Identifier
1801050612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9887
- Practice address
- 4420 Dixie Hwy Ste 110
Louisville, KY 40216-2986 - Phone
- (502) 447-3323
- Fax
- (913) 752-9116
- NPI assigned
- Jul 11, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9887 | KY | |
| General Practice Dentistry | 1223G0001X | 9887 | KY | Primary |
Addresses
Primary practice location
4420 Dixie Hwy Ste 110
Louisville, KY 40216-2986
Mailing address
2822 Shoemaker Dr
Louisville, KY 40241-6501
Phone (313) 204-4775
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9691 | NC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Serenity Smile Care, LLC | Current | Accepting new patients |
Locations
322 N Indiana Ave
Sellersburg, IN 47172
Phone (313) 204-4775
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.
-
- Dental Clinic/Center
- Sellersburg, IN
- NPI 1356086276
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517184000000",
"number": "1801050612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2822 SHOEMAKER DR",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402416501",
"telephone_number": "313-204-4775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4420 DIXIE HWY STE 110",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402162986",
"telephone_number": "502-447-3323",
"fax_number": "913-752-9116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOTEN-KERR",
"first_name": "JANEICE",
"middle_name": "AISHA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-11",
"last_updated": "2018-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "9887",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "9887",
"primary": true
}
],
"identifiers": [],
"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 Jan 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.