DR. JUSTIN MICHAEL RAYBOULD (NPI# 1689817579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689817579 |
| Entity Type | Individual |
| Full Name | DR. JUSTIN MICHAEL RAYBOULD |
| Credential | D.M.D. |
| Practice Address |
4384 Clearwater Way Suite 150 Lexington KY 40515-6477 |
| Mailing Address |
725 Beechmont Rd Suite 150 Lexington KY 40502-2837 |
| Practice Telephone | 8593217051 |
| Mailing Telephone | 8593217051 |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2015-02-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
8732 | KY | Dental Providers |
| Street Address |
4384 CLEARWATER WAY SUITE 150 |
| City | LEXINGTON |
| State | KY |
| Zip Code | 40515-6477 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992871644 | Veterans Park Family Dentistry Pllc | Dentist | 4384 Clearwater Way, Ste 110, Lexington, KY 40515-6337 | 2006-11-27 |
| 1194115857 | Lexington Children's Dentistry | Dentist | 4384 Clearwater Way, Suite 150, Lexington, KY 40515-6477 | 2015-02-02 |
| 1174912224 | Modern Kids Dentistry | Dentist | 4384 Clearwater Way, Suite 150, Lexington, KY 40515-6477 | 2015-01-13 |
| 1609935220 | Nicole Fallahzadeh Jenkins | Dentist | 4384 Clearwater Way, Ste 110, Lexington, KY 40515-6337 | 2006-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730699620 | Cassandra Grace Reynolds | Occupational Therapy Assistant | 3900 Crosby Dr Apt 102, Lexington, KY 40515 | 2017-10-04 |
| 1447793401 | Audrey Mccall Logan | Counselor | 3479 Buckhorn Drive, Ste 106, Lexington, KY 40515 | 2016-11-23 |
| 1043760465 | Mary Lauren Elizabeth Willis | Pharmacist | 4251 Mooncoin Way, Lexington, KY 40515 | 2016-10-10 |
| 1417334103 | William Douglas Hacker | Pediatrics | 4856 Pleasant Grove Road, Lexington, KY 40515 | 2015-05-01 |
| 1528480340 | Frances Ann Cook | Psychologist | 4105 Heartwood Rd, Lexington, KY 40515 | 2014-01-14 |
| 1245574532 | Patricia H Woodruff | Nurse Practitioner | 3030 Brookmonte Ln, Lexington, KY 40515 | 2012-11-27 |
| 1225381064 | Tiffany Kruger | Physical Therapist | 1092 Duval St Ste 210, Lexington, KY 40515 | 2012-10-17 |
| 1356698203 | Jessika Cordell Vance-morgan | Behavioral Analyst | 945 Darda Ct, Lexington, KY 40515 | 2012-08-09 |
| 1285915363 | Southern Office Solutions | Specialist | 5060 Ivybridge Dr., Lexington, KY 40515 | 2011-09-02 |
| 1578794426 | Emilie Carter | Social Worker | 1096 Duval St Ste 140, Lexington, KY 40515 | 2009-07-27 |
| Find all providers in zip 40515 | ||||
| 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 |
|---|---|---|---|---|
| 1164876280 | Kyle Clayton Kirk | Dentist | 2517 Sir Barton Way # 200, Lexington, KY 40509 | 2016-04-14 |
| 1528429644 | Stephanie Silva | Dentist | 5080 Sunset Blvd Ste B, Lexington, SC 29072-7051 | 2016-03-16 |
| 1841667037 | Midlands Pediatric Dentistry LLC | Dentist | 253 Cedarcrest Dr, Lexington, SC 29072-3812 | 2015-08-24 |
| 1639571607 | Sunset Children's Dentistry | Dentist | 5080 Sunset Blvd, Suite B, Lexington, SC 29072-7051 | 2014-09-22 |
| 1043655392 | Emilee Young Sexton | Dentist | 2549 Sun Seeker Ct, Lexington, KY 40503-2980 | 2013-04-30 |
| 1295920346 | Wild Smiles, LLC | Dentist | 203 North Lake Drive, Lexington, SC 29072 | 2007-09-12 |
| 1639361785 | Daniel John Steckler | Dentist | Ky Clinic Dentistry, Room A-219, Lexington, KY 40536-0001 | 2007-08-13 |
| 1699975904 | Justin C. Clemens | Dentist | 620 Perimeter Dr., Suite 103, Lexington, KY 40517 | 2007-07-24 |
| 1417078726 | Tommy Christopher Burke | Dentist | 10855 Highway 412 W, Lexington, TN 38351-6283 | 2007-04-03 |
| 1699819524 | Dentistry for Children | Dentist | 216 Fountain Court, Suite 150, Lexington, KY 40509 | 2007-02-16 |
| Find all providers in LEXINGTON | ||||
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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.