Individual provider Active NPI

Jenna R Schulten, DMD

  • Pediatric Dentistry
  • Louisville, KY
National Provider Identifier
1821317132
Registry record updated Sep 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
8868 Issued in KY
Practice address
1001 N Dupont SQ
Louisville, KY 40207-4612
Phone
(270) 789-7890
NPI assigned
May 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 8868 KY Primary

Addresses

Primary practice location

1001 N Dupont SQ
Louisville, KY 40207-4612

Mailing address

1103 Delor Ave
Louisville, KY 40217-2226
Phone (270) 789-7890

Other identifiers 1

IdentifierTypeStateIssuer
7100151020MedicaidKY

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8868KYMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dupont Pediatric Dentistry Pediatric Dentistry Current Accepting new patients

Locations

1001 N DuPont Sq
Louisville, KY 40207
Phone (502) 895-2334

3934 Dutchmans Ln
Louisville, KY 40207
Phone (502) 897-0625

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": "1274832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1821317132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 DELOR AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402172226",
            "telephone_number": "270-789-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N DUPONT SQ",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074612",
            "telephone_number": "270-789-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTEN",
        "first_name": "JENNA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-26",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "8868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100151020",
            "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 Sep 3, 2014; 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.