Morehead Peds Dre LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

MOREHEAD PEDS DRE LLC

Practice address

1275 Hallwood Dr
Morehead, KY 40351-7370

Phone

(606) 784-8000

NPI assigned

Nov 16, 2023

Organization subpart

No

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

Authorized official

Name

Elizabeth Davis

Title

Director of Revenue

Phone

(859) 533-1109

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1700092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700092800000",
    "number": "1891560272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SPRUCE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405072109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 HALLWOOD DR",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403517370",
            "telephone_number": "606-784-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOREHEAD PEDS DRE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-16",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE",
        "authorized_official_telephone_number": "859-533-1109"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Pollard Moore, APRN, CNM
• Maci Moore
• Morehead Pediatric Dentistry, PLLC
• Morehead Pediatrics
• Morehead Pediatrics
• Morehead Primary Care PLLC
• Morehead State University (Morehead State University Counsel & Health Services)
• Jasmine Morris
• Jonia Morris
• Kimberly Morris, M.S.,CCC/SLP

• Pediatric Dentistry in Morehead, KY
• Providers in Morehead, KY by specialty
• Pediatric Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.