LARRY GORDON PHILLIPS (NPI# 1366458960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366458960 |
| Entity Type | Individual |
| Full Name | LARRY GORDON PHILLIPS |
| Credential | D.M.D. |
| Practice Address |
4514 Outer Loop Louisville KY 40219-3857 |
| Practice Telephone | 5029699264 |
| Practice Fax Number | 5029699535 |
| Mailing Telephone | 5029699264 |
| Mailing Fax Number | 5029699535 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
4510 | KY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 60045101 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225058266 | Larry C. Phillips II | Physician Assistant | 441 E Piney Forest Rd, Danville, VA 24540 | 2006-07-20 |
| 1073510368 | Larry Ewing Phillips | Urology | 2503 Highway 281n, Suite 400, Marble Falls, TX 78654 | 2005-07-01 |
| 1619585841 | Larry Phillips | Behavior Technician | 1301 E Orangewood Ave, Anaheim, CA 92805-6807 | 2020-07-14 |
| 1972729804 | Larry S Phillips | Counselor | 7936 S Essex Ave, Chicago, IL 60617 | 2007-04-18 |
| 1073671012 | Larry Phillips | Counselor | 1410 Pickwick St S, Savannah, TN 38372-3519 | 2006-12-04 |
| Street Address |
4514 OUTER LOOP |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40219-3857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255948154 | Kathleen B Berghausen | Nurse Practitioner | 4112 Fern Valley Rod, Louisville, KY 40219 | 2020-09-25 |
| 1174165989 | Joann Deborah Hobbs | Nurse Practitioner | 8216 Delido Rd, Louisville, KY 40219 | 2019-10-14 |
| 1962989319 | Jennifer Lynn Pinkerton | Hearing Instrument Specialist | 7326 Preston Hwy, Suite 206a, Louisville, KY 40219 | 2018-07-27 |
| 1942748447 | Melissa Freeman Emanuele | Speech-Language Pathologist | 1550 Raydale Drive, Lousville, KY 40219 | 2017-02-03 |
| 1083014013 | Christopher Maxey | Specialist/Technologist | Fern Valley Rd, Louisville, KY 40219 | 2014-08-27 |
| 1679985949 | Antwan Turner | Case Manager/Care Coordinator | 5523 Saxon Blvd, Louisville, KY 40219 | 2014-05-21 |
| 1386055168 | Kelly Larson | Case Manager/Care Coordinator | 6809 Bebe Ct., Louisville, KY 40219 | 2014-05-14 |
| 1639414626 | Prettysmilesdenturesandmorellc | Dentist | 19123 West Mcnichols Rd, Detroit, MI 40219 | 2012-12-03 |
| 1881967701 | Vickie Lynn Dixon | Homemaker | 3516 Templewood Dr., Louisville, KY 40219 | 2012-02-23 |
| 1811157555 | Tonya Lynn Frost | Chiropractor | 4300 Outer Loop Ste 10, Louisville, KY 40219 | 2008-06-16 |
| Find all providers in zip 40219 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518599802 | Derby City Pediatric Dentistry, Pllc | Dentist | 2120 High Wickham Pl Ste 103, Louisville, KY 40245-5903 | 2020-02-05 |
| 1588204655 | Kids Dentistree of Ky LLC | Dentist | 8727 Old Bardstown Rd, Louisville, KY 40291-4490 | 2020-01-07 |
| 1780141580 | Morgan Marie Nowery | Dentist | 134 Gillette Ave, Louisville, KY 40214-1914 | 2019-02-27 |
| 1578030995 | Huda Hussain Alkuhl | Dentist | 501 S Preston St Fl 3, Louisville, KY 40202-1701 | 2018-10-24 |
| 1083144265 | Kelly Wessel | Dentist | 4413 Santa Paula Ln, Louisville, KY 40219-3820 | 2017-06-19 |
| 1548620560 | Myron F Shuster Dmd Psc | Dentist | 3101 Breckenridge Ln Ste 4b, Louisville, KY 40220-2797 | 2016-03-03 |
| 1396138616 | Uday K Bahunutula | Dentist | 2002 Fandango Ct, Louisville, KY 40245-5441 | 2015-03-11 |
| 1255757852 | Dupont Pediatric Dentistry | Dentist | 1001 Dupont Square North, Louisville, KY 40207 | 2014-03-07 |
| 1659610269 | Kids Dentistry- Dixie Highway Pllc | Dentist | 9707 Dixie Hwy, B, Louisville, KY 40272-3939 | 2013-02-04 |
| 1821317132 | Jenna R Schulten | Dentist | 1001 N Dupont Sq, Louisville, KY 40207-4612 | 2010-05-26 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40219 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.