Active NPI
Keith Leslie Ray, D.M.D.
- Pediatric Dentistry
- Louisville, KY
National Provider Identifier
1902896814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 5018
- Practice address
- 5713 Bardstown Rd
Louisville, KY 40291-1913 - Phone
- (502) 231-1418
- Fax
- (502) 231-0051
- NPI assigned
- Oct 24, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 5018 | KY | Primary |
Addresses
Primary practice location
5713 Bardstown Rd
Louisville, KY 40291-1913
Mailing address
5713 Bardstown Rd
Louisville, KY 40291-1913
Phone (502) 231-1418
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60050184 | Medicaid | KY |
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 |
|---|---|---|---|
| 5018 | KY | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483488000000",
"number": "1902896814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5713 BARDSTOWN RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402911913",
"telephone_number": "502-231-1418",
"fax_number": "502-231-0051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5713 BARDSTOWN RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402911913",
"telephone_number": "502-231-1418",
"fax_number": "502-231-0051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAY",
"first_name": "KEITH",
"middle_name": "LESLIE",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-24",
"last_updated": "2017-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "KY",
"license": "5018",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "60050184",
"state": "KY"
}
],
"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 Jan 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.