Individual provider Active NPI

Julia Broaddus Dobson, DMD

  • Pediatric Dentistry
  • Louisville, KY
National Provider Identifier
1831544329
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
9762 Issued in KY
Practice address
2813 N Hurstbourne Pkwy Ste 106
Louisville, KY 40223-1281
Phone
(502) 640-0920
NPI assigned
May 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9762 KY
Pediatric Dentistry 1223P0221X 9762 KY Primary

Addresses

Primary practice location

2813 N Hurstbourne Pkwy Ste 106
Louisville, KY 40223-1281

Mailing address

2813 N Hurstbourne Pkwy Ste 106
Louisville, KY 40223-1281
Phone (502) 640-0920

Other identifiers 1

IdentifierTypeStateIssuer
7101060300MedicaidKY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160809001107 KY Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 5092009340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9762KYMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1831544329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2813 N HURSTBOURNE PKWY STE 106",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402231281",
            "telephone_number": "502-640-0920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2813 N HURSTBOURNE PKWY STE 106",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402231281",
            "telephone_number": "502-640-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBSON",
        "first_name": "JULIA",
        "middle_name": "BROADDUS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9762",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "9762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7101060300",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.