DR. JACK GOLDBERG SHTEREMBERG (NPI# 1710388111) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710388111 |
| Entity Type | Individual |
| Full Name | DR. JACK GOLDBERG SHTEREMBERG |
| Credential | DDS, MS |
| Practice Address |
501 S Preston St Louisville KY 40202-1701 |
| Mailing Address |
1104 Mallard Creek Rd Louisville KY 40207-5811 |
| Practice Telephone | 5028526928 |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2014-09-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
9549 | KY | Dental Providers |
| Street Address |
501 S PRESTON ST |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40202-1701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326043555 | Wendy Stavrides Hupp | Dentist | 501 S Preston St, Louisville, KY 40202-1701 | 2005-06-15 |
| 1598393183 | Timothy Michael Haffner | Student in an Organized Health Care Education/Training Program | 501 S Preston St, Louisville, KY 40202-1701 | 2020-03-30 |
| 1174166821 | Muhammad Saleh | Dentist | 501 S Preston St, Louisville, KY 40202-1701 | 2019-10-25 |
| 1639729593 | Gustavo Machado Santaella | Dentist | 501 S Preston St, Louisville, KY 40202-1701 | 2019-09-12 |
| 1235796988 | Daniel Flaherty Ritchey | Dentist | 501 S Preston St, Louisville, KY 40202-1701 | 2019-05-28 |
| 1184280778 | Jonathan Thomas | Student in an Organized Health Care Education/Training Program | 501 S Preston St, Louisville, KY 40202-1701 | 2019-05-20 |
| 1669939559 | Evan M Harpster | Dentist | 501 S Preston St, Louisville, KY 40202-1701 | 2019-02-27 |
| 1275099624 | Aikaterini Kavvadia | Dentist | 501 S Preston St, Louisville, KY 40202-1701 | 2019-02-11 |
| 1316431372 | Parker Haycock | Dentist | 501 S Preston St, Louisville, KY 40202-1701 | 2018-06-21 |
| 1679066526 | Troy Bancha Tran | Dentist | 501 S Preston St, Louisville, KY 40202-1701 | 2018-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972129682 | Garvit Chhabra | Student in an Organized Health Care Education/Training Program | 550, South Jackson Street, Acb, Third Floor, Louisville, KY 40202 | 2020-06-18 |
| 1396367009 | Richele Williams | Student in an Organized Health Care Education/Training Program | 201 Abraham Flexner Way Department of Family and Pediac, Suite 690, Louisville, KY 40202 | 2020-05-15 |
| 1942822028 | Ahmed Khaled Saleh | Student in an Organized Health Care Education/Training Program | 500 S Jackson St, Room 305, Louisville, KY 40202 | 2020-05-12 |
| 1457972952 | Mir Ali Raza Talpur | Student in an Organized Health Care Education/Training Program | 401 E Chestnut Street, Suite 600 University of Louisvi, Louisville, KY 40202 | 2020-05-06 |
| 1316575533 | Abigail Hatfield | Student in an Organized Health Care Education/Training Program | Internal Medicine Training Program, 550 South Jackson Street, Acb 3rd Floor, Louisville, KY 40202 | 2020-04-01 |
| 1851929210 | Madison Harmon | Student in an Organized Health Care Education/Training Program | Uofl Department of Emergency Medicine, 530 S. Jackson Street Room C1h17, Louisville, KY 40202 | 2020-03-31 |
| 1184252041 | Marianna Weaver | Student in an Organized Health Care Education/Training Program | 550 South Jackson Street, Acb 3rd Floor, University of Louisville, Louisville, KY 40202 | 2020-03-27 |
| 1700347341 | Charles Jake Sadle | Student in an Organized Health Care Education/Training Program | Office of Medical Education C/o Brittney Luckett, 571 S. Floyd St., Ste. 412, Louisville, KY 40202 | 2019-03-27 |
| 1437616794 | Paladina Health, LLC | Family Medicine | Paladina Health Humana East, 123 E Main Street, Louisville, KY 40202 | 2019-02-22 |
| 1205393568 | Paladina Health, LLC | Family Medicine | Paladina Health Humana West, 500 W Main Street, Louisville, KY 40202 | 2019-02-22 |
| Find all providers in zip 40202 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346687803 | Jyme Rae Charette | Dentist | 7807 Shelbyville Rd Ste 202, Louisville, KY 40222-9000 | 2013-05-23 |
| 1760513675 | Sarah Foard Johnson | Dentist | 2934 Breckenridge Ln Ste 1, Louisville, KY 40220-3903 | 2007-03-09 |
| 1225536683 | Advanced Dental Solutions LLC | Dentist | 134 Evergreen Rd Ste 201, Louisville, KY 40243 | 2018-01-31 |
| 1902352784 | Wasan Amornsang | Dentist | 401 E Chestnut St, Suite 550, Louisville, KY 40202-5700 | 2016-08-31 |
| 1952447633 | Allan D Linehan | Dentist | 1160 Bardstown Rd, Louisville, KY 40204-1359 | 2007-01-29 |
| 1679668222 | Ann M Windchy | Dentist | University of Louisville School of Dentistry, 501 S. Preston St., Louisville, KY 40292 | 2006-10-03 |
| 1093808735 | Mark C Nation | Dentist | University of Louisville School of Dentistry, 501 S. Preston St., Louisville, KY 40292 | 2006-10-02 |
| 1295837284 | Marion Jackson Edge | Dentist | University of Louisville School of Dentistry, 501 S. Preston St., Louisville, KY 40292-0001 | 2006-09-01 |
| 1669584017 | Thomas Kendall Binkley | Dentist | University of Louisville School of Dentistry, 501 S. Preston St., Louisville, KY 40292-0001 | 2006-08-31 |
| 1982672150 | Zafrulla Khan | Dentist | 529 S Jackson St, Brown Cancer Center Ste 127, Louisville, KY 40202-3229 | 2006-03-14 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40202 |
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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.