Wise Dentistry Dre LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

WISE DENTISTRY DRE LLC

Practice address

105 Medical Park Dr Ste 1
Campbellsville, KY 42718-7639

Phone

(270) 469-1403

NPI assigned

Nov 16, 2023

Organization subpart

No

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

Authorized official

Name

Elizabeth Davis

Title

Director of Revenue

Phone

(859) 533-1109

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Heather Hood Wise, D.M.D

  • Pediatric Dentistry
  • Campbellsville, KY
  • NPI 1053439554
  NPD (past)

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

{
    "created_epoch": "1700092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700092800000",
    "number": "1801661285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SPRUCE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405072109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MEDICAL PARK DR STE 1",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427187639",
            "telephone_number": "270-469-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE DENTISTRY DRE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-16",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE",
        "authorized_official_telephone_number": "859-533-1109"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Carol Wilcoxson
• Harold T. Wilkerson, DMD
• Maridith Ann Willett, M.S., OTR/L
• William D. Feltner, D.O., PSC
• Sabrina Willis, M.S, CCC-SLP, CLC
• Wise Dentistry for Kids, PSC
• Heather Hood Wise, D.M.D
• Wittum Psychological Services LLC
• Karen Wolfe, ARNP, CNM
• Women'S Health Center of Central Kentucky, PLLC

• Pediatric Dentistry in Campbellsville, KY
• Providers in Campbellsville, KY by specialty
• Pediatric Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.