Active NPI
Alessandro Pedercini
- Periodontics
- Louisville, KY
National Provider Identifier
1851884712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 11077
- Practice address
- 501 S Preston St
Louisville, KY 40202-1701 - Phone
- (502) 852-5401
- NPI assigned
- Jun 14, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 11077 | KY | Primary |
Addresses
Primary practice location
501 S Preston St
Louisville, KY 40202-1701
Mailing address
501 S Preston St RM 107
Louisville, KY 40202-1701
Phone (502) 852-7573
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11077 | KY | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717372800000",
"number": "1851884712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 S PRESTON ST RM 107",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021701",
"telephone_number": "502-852-7573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 S PRESTON ST",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402021701",
"telephone_number": "502-852-5401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDERCINI",
"first_name": "ALESSANDRO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-14",
"last_updated": "2024-06-03",
"certification_date": "2024-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "KY",
"license": "11077",
"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 Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.