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KIDS DENTISTRY-JEFFERSON MALLPLLC NPI 1639357502


NPI Information

NPI: 1639357502
Provider Name: KIDS DENTISTRY-JEFFERSON MALL,PLLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
5100 OUTER LOOP
SUITE C
LOUISVILLE, KY
ZIP 40219
Phone: (502) 969-9266
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KIDS DENTISTRY-JEFFERSON MALL,PLLC is a dental clinic center in Louisville, KY. KIDS DENTISTRY-JEFFERSON MALL,PLLC NPI is 1639357502. The provider is registered as an organization entity type.

The provider's business location address is:

5100 OUTER LOOP
SUITE C
LOUISVILLE, KY
ZIP 40219-056
Phone: (502) 969-9266
Fax: (502) 254-6054

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

The enumeration date for this NPI number is 2/4/2008 and was last updated on 1/19/2011.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QD0000XClinic/CenterDentalYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.