WHITE LAVENDER NPI 1285462663

NPI Information

  • NPI: 1285462663
  • Provider Name: WHITE LAVENDER
  • Classification: Dentist - 1223X2210X
  • Specialization: Orofacial Pain
  • Entity Type: Organization
  • Address: 4122 SHELBYVILLE RD STE A
    LOUISVILLE, KY
    ZIP 40207
  • Phone: (502) 805-3074

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NPI Details

WHITE LAVENDER is an orofacial pain dentist in Louisville, KY. The provider is a dentist who assesses, diagnoses, and treats patients with complex chronic orofacial pain and dysfunction disorders, oromotor and jaw behavior disorders, and chronic head/neck pain. The dentist has successfully completed an accredited postdoctoral orofacial pain residency training program for dentists of two or more years duration, in accord with the Commission on Dental Accreditation's Standards for Orofacial Pain Residency Programs, and/or meets the requirements for examination and board certification by the American Board of Orofacial Pain. WHITE LAVENDER NPI is 1285462663. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4122 SHELBYVILLE RD STE A
LOUISVILLE, KY
ZIP 40207-212
Phone: (502) 805-3074
Fax: (502) 251-0922

The provider's authorized official is Micah Donlon .
The authorized official title is Founder and has the following contact phone number (502) 805-3074.

The enumeration date for this NPI number is 7/25/2024 and was last updated on 8/23/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223X2210XDentistOrofacial PainYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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