NPIMap

Organization Active NPI

Oak Tree Dental PLLC

Doing business as Revitalize Dental

  • Dental Clinic/Center
  • Louisville, KY
National Provider Identifier
1871320663
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
OAK TREE DENTAL PLLC
Doing business as
Revitalize Dental
Practice address
2323 Lime Kiln LN
Louisville, KY 40222-3416
Phone
(502) 423-0781
NPI assigned
Sep 17, 2024
Last updated
Sep 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Authorized official

Name
Mrs. Sheila Shain
Title
Practice Director
Phone
(502) 386-7147

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

2323 Lime Kiln LN
Louisville, KY 40222-3416

Mailing address

2323 Lime Kiln LN
Louisville, KY 40222-3416
Phone (502) 423-0781

Other names 1

  • Revitalize Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1871320663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 LIME KILN LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402223416",
            "telephone_number": "502-423-0781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 LIME KILN LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402223416",
            "telephone_number": "502-423-0781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK TREE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "SHAIN",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "PRACTICE DIRECTOR",
        "authorized_official_telephone_number": "502-386-7147",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revitalize Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 17, 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.

Verify at the official NPI Registry.