Individual provider Active NPI

Janeice Aisha Wooten-Kerr, DDS

  • General Practice Dentistry
  • Louisville, KY
National Provider Identifier
1801050612
Registry record updated Jan 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9887 Issued in KY
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

Updated by the provider on Jan 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
9691NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Smile Care, LLC CurrentSince May 8, 2022 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.

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.

Verify at the official NPI Registry.