DENTAL SURGICENTER OF LOUISVILLE INC NPI 1487043386

NPI Information

NPI: 1487043386
Provider Name: DENTAL SURGICENTER OF LOUISVILLE INC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
2800 CANNONS LN
SUITE 100
LOUISVILLE, KY
ZIP 40205
Phone: (502) 813-8604
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DENTAL SURGICENTER OF LOUISVILLE INC is an ambulatory surgical clinic center in Louisville, KY. DENTAL SURGICENTER OF LOUISVILLE INC NPI is 1487043386. The provider is registered as an organization entity type.

The provider's business location address is:

2800 CANNONS LN
SUITE 100
LOUISVILLE, KY
ZIP 40205-164
Phone: (502) 813-8604
Fax: (502) 813-8612

The provider's authorized official is Nathan F. Walters .
The authorized official title is President and has the following contact phone number (502) 454-4885.

The enumeration date for this NPI number is 1/15/2015 and was last updated on 2/19/2020.

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
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	300002398	MEDICAID	INDIANA
2	7100464170	MEDICAID	KENTUCKY

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: 4/28/2024

NPI Synchronization or Removal

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