DR. LAMONT RAY GHOLSTON (NPI# 1417190562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417190562 |
| Entity Type | Individual |
| Full Name | DR. LAMONT RAY GHOLSTON |
| Credential | DMD |
| Practice Address |
928 E Broadway Louisville KY 40204-1057 |
| Practice Telephone | 5025810015 |
| Practice Fax Number | 5025822368 |
| Mailing Telephone | 5025810015 |
| Mailing Fax Number | 5025822368 |
| Enumeration Date | 2009-04-18 |
| Last Update Date | 2009-04-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
4585 | KY | Dental Providers |
| Street Address |
928 E BROADWAY |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40204-1057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619434974 | Paladina Health, LLC | Family Medicine | Paladina Health Louisville Centerstone Broadway, 914 East Broadway Suite 200, Louisville, KY 40204 | 2019-02-22 |
| 1821317975 | Abby Fowler | Social Worker | 1357 Bardstown Rd, Louisville, KY 40204 | 2010-05-27 |
| 1033317441 | Katrina Laflesh | Counselor | 914 East Broadway, 3rd Floor, Louisville, KY 40204 | 2007-07-06 |
| 1770790891 | Richard Brooks | Counselor | 914 East Broadway 1st, Louisville, KY 40204 | 2007-05-17 |
| 1447302922 | Walden Chiropractic Psc | Chiropractor | 1072 Bardstown Road, Louisville, KY 40204 | 2007-01-17 |
| 1053485938 | Hanger Prosthetics & Orthotics East Inc | Durable Medical Equipment & Medical Supplies | 1023 E Broadway, Louisville, KY 40204 | 2006-11-20 |
| 1710072137 | Sandra L. Payne | Dentist | John P Rakutt Dmd Psc, 801 Barret Avenue #107, Louisville, KY 40204 | 2006-10-03 |
| 1013017482 | Bonnie L Varisco | Social Worker | 914 E. Broadway, 2nd, Louisville, KY 40204 | 2006-09-25 |
| 1902854334 | Kevin B Spicer | Pediatrics | 834 E Broadway, Louisville, KY 40204 | 2006-05-05 |
| 1992777213 | Donna Maclain Stewart | Pathology | Office of The Chief Medical Examiner;urban Government C, 810 Barret Ave, Louisville, KY 40204 | 2006-02-02 |
| Find all providers in zip 40204 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164089231 | Brian Barrett Glatt | Dentist | 304 Axis Dr Apt 201, Louisville, KY 40206-0169 | 2019-05-23 |
| 1942760996 | Danielle Cianciolo | Dentist | 205 Tyne Rd, Louisville, KY 40207-3443 | 2019-03-24 |
| 1033604327 | Bbb of In, LLC | Dentist | 11801 Brinley Ave Ste 100, Louisville, KY 40243-3006 | 2018-06-28 |
| 1649765462 | Bbb of Ky, LLC | Dentist | 5225 Dixie Hwy, Louisville, KY 40216 | 2018-06-25 |
| 1194096115 | V.s. Degeorge, Dmd, Psc | Dentist | 8013 New Lagrange Road, Suite #3, Louisville, KY 40222-4077 | 2012-01-23 |
| 1326349283 | Robert J Edwards | Dentist | 877 E South Boulder Rd, Louisville, CO 80027 | 2010-11-09 |
| 1306165758 | Heather Renae Mccullum | Dentist | 3827 Taylorsville Rd, Louisville, KY 40220-1345 | 2010-05-25 |
| 1154649705 | Matthew Alan Akridge | Dentist | 12405 Old Shelbyville Rd, Louisville, KY 40243-1505 | 2010-05-06 |
| 1578723169 | Hannah Rae Oliver | Dentist | 6613 Everton Dr, Louisville, KY 40258-3368 | 2008-06-17 |
| 1558587014 | Carol M Summe | Dentist | 140 Chenoweth Ln, Louisville, KY 40207-2651 | 2007-04-17 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40204 |
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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.