Licking Valley Dental Associates PSC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4932 Issued in KY

Legal business name

LICKING VALLEY DENTAL ASSOCIATES PSC

Practice address

114 S Main St
Cynthiana, KY 41031-1521

Phone

(859) 234-3323

Fax

(859) 234-3332

NPI assigned

Dec 27, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James Stephen Clyde, DMDNPI 1538232194

Title

President

Phone

(859) 234-3323

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James Stephen Clyde, DMD

  • General Practice Dentistry
  • Cynthiana, KY
  • NPI 1538232194
  NPD (past) Authorized official
• Christopher Kerns, DMD

  • Dental Laboratory Technician
  • Cynthiana, KY
  • NPI 1265726863
  NPD (past)
• Danielle N Pickinpaugh

  • Dentist
  • Louisville, KY
  • NPI 1700453578
  NPD (past)

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982769154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 S MAIN ST",
            "city": "CYNTHIANA",
            "state": "KY",
            "postal_code": "410311521",
            "telephone_number": "859-234-3323",
            "fax_number": "859-234-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 S MAIN ST",
            "city": "CYNTHIANA",
            "state": "KY",
            "postal_code": "410311521",
            "telephone_number": "859-234-3323",
            "fax_number": "859-234-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LICKING VALLEY DENTAL ASSOCIATES PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLYDE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-234-3323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "4932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dwana Knapp, MSW
• Trevor Cole Kohari, DO
• Ky Chiropractic Cynthiana PLLC
• Jayda Lail, IECE CERTIFICATE
• Dwight E Lewis Jr., M.D.
• Licking Valley Internal Medicine & Pediatrics PSC
• Faith Louthan
• James Michael Luckett
• James B Lunsford, CRNA
• Christopher Maechler

• General Practice Dentistry in Cynthiana, KY
• Providers in Cynthiana, 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 Aug 22, 2020; 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.