PERIODONTIC & ENDODONTIC SERVICES-JEFFERSON MALL PLLC NPI 1578853982

NPI Information

NPI: 1578853982
Provider Name: PERIODONTIC & ENDODONTIC SERVICES-JEFFERSON MALL, PLLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
5100 OUTER LOOP
STE B
LOUISVILLE, KY
ZIP 40219
Phone: (502) 966-8660
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PERIODONTIC & ENDODONTIC SERVICES-JEFFERSON MALL, PLLC is a dental clinic center in Louisville, KY. PERIODONTIC & ENDODONTIC SERVICES-JEFFERSON MALL, PLLC NPI is 1578853982. The provider is registered as an organization entity type.

The provider's business location address is:

5100 OUTER LOOP
STE B
LOUISVILLE, KY
ZIP 40219-056
Phone: (502) 966-8660

The provider's authorized official is Steve James .
The authorized official title is Cfo and has the following contact phone number (502) 254-8504.

The enumeration date for this NPI number is 4/19/2011 and was last updated on 4/19/2011.

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	261QD0000X	Clinic/Center	Dental			Yes

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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