Individual provider Active NPI

Stetson Earl, DMD

  • General Practice Dentistry
  • Florence, KY
National Provider Identifier
1902466329
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10647 Issued in KY
Practice address
7000 Houston Rd Ste 35
Florence, KY 41042-4879
Phone
(859) 371-0183
NPI assigned
Jun 18, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11338411-9922 UT
General Practice Dentistry 1223G0001X 30.026176 OH
General Practice Dentistry 1223G0001X 10647 KY Primary

Addresses

Primary practice location

7000 Houston Rd Ste 35
Florence, KY 41042-4879

Mailing address

7000 Houston Rd Ste 35
Florence, KY 41042-4879
Phone (859) 371-0183

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

LicenseStateTypeSpecialty
10647KYMDGeneral Practice Dentistry
30.026176OHMDGeneral Practice Dentistry
11338411-9922UTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1902466329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 HOUSTON RD STE 35",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410424879",
            "telephone_number": "859-371-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 HOUSTON RD STE 35",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410424879",
            "telephone_number": "859-371-0183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARL",
        "first_name": "STETSON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-18",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "11338411-9922",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.026176",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "10647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.