NPIMap

Organization Active NPI

Edgewood Dental Care PSC

  • General Practice Dentistry
  • Edgewood, KY
National Provider Identifier
1841693033
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6007 Issued in KY
Legal business name
EDGEWOOD DENTAL CARE PSC
Practice address
155 Barnwood Drive
Ste 1
Edgewood, KY 41017
Phone
(859) 331-3400
Fax
(859) 331-6429
NPI assigned
Oct 1, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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

Authorized official

Name
Dr. Kevin McMahon, DMDNPI 1205971082
Title
Dentist
Phone
(859) 331-3400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 6007 KY Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 4333 KY
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 8628 KY
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 9229 KY

Addresses

Primary practice location

155 Barnwood Drive
Ste 1
Edgewood, KY 41017

Mailing address

155 Barnwood Dr
Suite 1
Edgewood, KY 41017-2585
Phone (859) 331-3400

National Provider Directory

National Provider Directory

Locations

155 Barnwood Dr
Ste 1
Edgewood, KY 41017
Phone (859) 331-3400

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412121600000",
    "number": "1841693033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 BARNWOOD DR",
            "address_2": "SUITE 1",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410172585",
            "telephone_number": "859-331-3400",
            "fax_number": "859-331-6429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 BARNWOOD DRIVE",
            "address_2": "STE 1",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "41017",
            "telephone_number": "859-331-3400",
            "fax_number": "859-331-6429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD DENTAL CARE PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-01",
        "status": "A",
        "authorized_official_last_name": "MCMAHON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "859-331-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "6007",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "4333",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "8628",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9229",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.