IDENTITY DENTAL STUDIO, PLLC (NPI# 1760975650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760975650 |
| Entity Type | Organization |
| Organization Name | IDENTITY DENTAL STUDIO, PLLC |
| Other Organization Name | IDS SMILE LAB |
| Practice Address |
541 Darby Creek Road Ste 190 Lexington KY 40509 |
| Practice Telephone | 8592872484 |
| Practice Fax Number | 8592872484 |
| Mailing Telephone | 8592872484 |
| Mailing Fax Number | 8592872484 |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2020-01-16 |
| Authorized Official Name | BRANDON M STAPLETON (DENTIST/OWNER) |
| Authorized Official Telephone | 8592872484 |
| Authorized Official Credential | DMD, MSD |
| Is Organization Subpart | Y |
| Parent Organization Name | IDENTITY DENTAL STUDIO, PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0700X |
Dentist Specialization: Prosthodontics |
9038 | KY | Dental Providers |
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| iDS Smile Lab | Doing Business As Name - Organization |
| Street Address |
541 DARBY CREEK ROAD STE 190 |
| City | LEXINGTON |
| State | KY |
| Zip Code | 40509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710409370 | Sleep Identity Pllc | Clinic/Center | 541 Darby Creek Road, Ste 190, Lexington, KY 40509 | 2017-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902453640 | Grace T. Hallak | Counselor | 513 Darby Creek Rd, Lexington, KY 40509 | 2019-08-19 |
| 1932755774 | Lexington-fayette Urban-county Health Department | Public Health or Welfare | 4801 Athens Boonesboro Rd, Lexington, KY 40509 | 2019-08-16 |
| 1497308266 | Discover You Counseling LLC | Social Worker | 513 Darby Creek Drive, Unit 56 D, Lexington, KY 40509 | 2019-07-22 |
| 1407323611 | Trevor Douglas Mchardy | Physician Assistant | 101 North Eagle Creek Drive, Lexington, KY 40509 | 2018-10-25 |
| 1114413184 | Megan Medrano | Dietitian, Registered | 163 Old Todds Rd Ste 115, Lexington, KY 40509 | 2018-07-02 |
| 1750884292 | Active Medical LLC | Durable Medical Equipment & Medical Supplies | 3470 Blazer Pkwy Ste 350, Lexington, KY 40509 | 2018-03-12 |
| 1699273599 | Frederick Douglas High School | Public Health or Welfare | 2000 Winchester Rd, Lexington, KY 40509 | 2018-01-25 |
| 1164956397 | Danielle Anderson | Family Medicine | 24 Fountain Court, Suite 225, Lexington, KY 40509 | 2017-04-14 |
| 1356891782 | Dawn Jones | Physician Assistant | 101 N Eagle Creek Dr, Ste 120, Lexington, KY 40509 | 2016-10-10 |
| 1740735786 | Kasey Puckett | Marriage & Family Therapist | 2525 Danielle Ln, Lexington, KY 40509 | 2016-08-19 |
| Find all providers in zip 40509 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942810882 | Lexington Smiles, Pllc | Clinic/Center | 123 S Randolph St, Lexington, VA 24450-2065 | 2020-08-05 |
| 1730700576 | Arrow Dental Pllc | Clinic/Center | 2505 Larkin Rd Ste 201, Lexington, KY 40503-3256 | 2020-05-04 |
| 1710409370 | Sleep Identity Pllc | Clinic/Center | 541 Darby Creek Road, Ste 190, Lexington, KY 40509 | 2017-07-14 |
| 1033341433 | White Knoll Dentistry, LLC | Clinic/Center | 5545 Platt Springs Rd, Lexington, SC 29073 | 2009-08-18 |
| 1821248162 | Dental Services of Kentucky, Psc | Clinic/Center | 2358 Nicholasville Rd, #156, Lexington, KY 40503-3032 | 2008-09-23 |
| 1831798222 | Advanced Dental Care of Lexington LLC | Clinic/Center | 948 Old Cherokee Rd, Lexington, SC 29072-8123 | 2020-10-19 |
| 1821614959 | Lexington Dental, Pllc | Clinic/Center | 302 Court Sq, Lexington, MS 39095-3630 | 2020-06-24 |
| 1376164954 | Arrow Dental Pllc | Clinic/Center | 2517 Sir Barton Way Ste 200, Lexington, KY 40509-2744 | 2020-05-05 |
| 1902427750 | Arrow Dental Pllc | Clinic/Center | 216 Fountain Ct, Lexington, KY 40509-2511 | 2020-05-04 |
| 1720628886 | Justice Dental Wellington | Clinic/Center | 535 Wellington Way Ste 120, Lexington, KY 40503-1387 | 2020-01-07 |
| 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.