Michael Robert Dick, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8722 Issued in KY

Practice address

3901 Dutchmans LN
Suite 201
Louisville, KY 40207-4722

Phone

(502) 895-2218

Fax

(502) 895-2268

NPI assigned

Jun 4, 2009

Last updated

Jun 4, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mortenson Family Dental Center-Dupont,PLLC

  dba Mortenson Family Dental Center - Hikes Point

  • Dental Clinic/Center
  • Louisville, KY
  • NPI 1457626095
  NPD (past)

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244073600000",
    "number": "1912133935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 DUTCHMANS LN",
            "address_2": "SUITE 201",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074722",
            "telephone_number": "502-895-2218",
            "fax_number": "502-895-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 DUTCHMANS LN",
            "address_2": "SUITE 201",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074722",
            "telephone_number": "502-895-2218",
            "fax_number": "502-895-2268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICK",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-04",
        "last_updated": "2009-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "8722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Dichiara
• Darrell Dichiara
• Tisha Dichristopher, APRN
• Rebecca Marie Dicicco, PA-C
• John Wesley Dick, PHARMD
• John Dickens, MD, MBA
• Jenna A Dickenson, PSY.D.
• Dickerson Family Enterprise, LLC (Dee's Senior Home Care)
• Donald Richard Dickerson III, MD STUDENT
• Jacob Dickerson

• General Practice Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.