Active NPI
Crofton Dental Center PLLC
- General Practice Dentistry
- Crofton, KY
National Provider Identifier
1982904637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7523
- Legal business name
- CROFTON DENTAL CENTER PLLC
- Practice address
- 115 E Mill St
Crofton, KY 42217-8021 - Phone
- (270) 424-5999
- Fax
- (270) 424-5522
- NPI assigned
- Oct 28, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Marty Edward Gamble, D.D.S.
- Title
- Dentist
- Phone
- (270) 424-5999
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7523 | KY | Primary |
Addresses
Primary practice location
115 E Mill St
Crofton, KY 42217-8021
Mailing address
115 E Mill St
Crofton, KY 42217-8021
Phone (270) 424-5999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60000304 | Medicaid | KY |
National Provider Directory
National Provider DirectoryLocations
115 E Mill St
Crofton, KY 42217
Phone (270) 424-5999
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288224000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1288224000000",
"number": "1982904637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 E MILL ST",
"city": "CROFTON",
"state": "KY",
"postal_code": "422178021",
"telephone_number": "270-424-5999",
"fax_number": "270-424-5522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 E MILL ST",
"city": "CROFTON",
"state": "KY",
"postal_code": "422178021",
"telephone_number": "270-424-5999",
"fax_number": "270-424-5522"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CROFTON DENTAL CENTER PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-10-28",
"last_updated": "2010-10-28",
"status": "A",
"authorized_official_last_name": "GAMBLE",
"authorized_official_first_name": "MARTY",
"authorized_official_middle_name": "EDWARD",
"authorized_official_title_or_position": "DENTIST",
"authorized_official_telephone_number": "270-424-5999",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.D.S."
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "7523",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "60000304",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Crofton, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.