Dhda Hebron, PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DHDA HEBRON, PLLC

Practice address

1930 Petersburg Rd
Hebron, KY 41048-8291

Phone

(859) 586-5620

NPI assigned

Feb 16, 2021

Organization subpart

Yes

Parent organization

DHDA PROVIDERCO, PLLCAs reported in NPPES

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

Authorized official

Name

Paul T Lavelle, DMD

Title

Clinical Director

Phone

(203) 921-6141

Specialties & licenses 1

Addresses

Part of

Dhda Providerco PLLC

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613433600000",
    "number": "1851984439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5404 FARM RIDGE LN",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400597617",
            "telephone_number": "203-921-6141",
            "fax_number": "502-547-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 PETERSBURG RD",
            "city": "HEBRON",
            "state": "KY",
            "postal_code": "410488291",
            "telephone_number": "859-586-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHDA HEBRON, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DHDA PROVIDERCO, PLLC",
        "enumeration_date": "2021-02-16",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "LAVELLE",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "203-921-6141",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; 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.