Dixie Dental Center PSC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DIXIE DENTAL CENTER PSC

Practice address

1480 Dixie Hwy
Louisville, KY 40210

Phone

(502) 778-7414

NPI assigned

Jan 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Rodney Brent Fultz, DMD

Title

Sec Treas

Phone

(502) 778-7414

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Dixie Dental Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dixie Dental Center

  • General Practice Dentistry
  • Louisville, KY
  • NPI 1679986160
  NPD tax ID

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197936000000",
    "number": "1962552042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 DIXIE HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40210",
            "telephone_number": "502-778-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 DIXIE HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40210",
            "telephone_number": "502-778-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIXIE DENTAL CENTER PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-12-18",
        "status": "A",
        "authorized_official_last_name": "FULTZ",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "BRENT",
        "authorized_official_title_or_position": "SEC TREAS",
        "authorized_official_telephone_number": "502-778-7414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61942355",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nannette Bertram Dix, CSW
• Dixie Chiropractic & Rehabilitation, PSC
• Dixie Chiropractic Office, P.S.C.
• Dixie Dental and Dentures LLC
• Dixie Dental Center
• Dixie Infusion Clinic, LLC
• Dixie Pharmacy LLC
• Dixie Primary Care LLC
• Ashwin Dixit, M.D.
• Bhargab Dixit, M.D.

• Dental Clinic/Center in Louisville, KY
• Providers in Louisville, KY by specialty
• Dental Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; 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.