DIXIE DENTAL CENTER PSC (NPI# 1962552042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962552042 |
| Entity Type | Organization |
| Organization Name | DIXIE DENTAL CENTER PSC |
| Practice Address |
1480 Dixie Hwy Louisville KY 40210 |
| Practice Telephone | 5027787414 |
| Mailing Telephone | 5027787414 |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2007-12-18 |
| Authorized Official Name | DR. RODNEY BRENT FULTZ (SEC TREAS) |
| Authorized Official Telephone | 5027787414 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 61942355 | 05 |
| Street Address |
1480 DIXIE HWY |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649260464 | David Neal Waugh | Dentist | 1480 Dixie Hwy, Louisville, KY 40210-1768 | 2005-10-24 |
| 1679986160 | Dixie Dental Center | Dentist | 1480 Dixie Hwy, Louisville, KY 40210-1768 | 2014-06-03 |
| 1194900100 | Mahyar Mofidi | Dentist | 1480 Dixie Hwy, Louisville, KY 40210 | 2008-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568919322 | Drjbcdc | Chiropractor | 1714 Dixie Hwy, Louisville, KY 40210 | 2016-09-08 |
| 1528494770 | Valerie Gholson Day | Marriage & Family Therapist | 1620 Anderson St, Louisville, KY 40210-1032 | 2013-09-19 |
| 1851821532 | Heart 2 Heart Veterans Care | Nurse's Aide | 2518 Osage Ave, Louisville, KY 40210-1116 | 2017-06-15 |
| 1588127310 | Klf Company LLC | Community/Behavioral Health | 1833 Date St, Louisville, KY 40210-1245 | 2019-04-09 |
| 1407305998 | Prorehab Louisville | Clinic/Center | 902 S 15th St, Louisville, KY 40210-1319 | 2016-09-26 |
| 1568070480 | Stimar Healthcare LLC | Nurse Practitioner | 2111 W Oak St, Louisville, KY 40210-1419 | 2020-07-16 |
| 1982240115 | Geri Ann Thomas | Nurse Practitioner | 2228 Hale Ave, Louisville, KY 40210-1436 | 2019-11-22 |
| 1649747882 | Tanika L. Owens | Kinesiotherapist | 1022 Dumesnil St., Louisville, KY 40210-1517 | 2018-10-25 |
| 1730559428 | Tnt Fitness Training, LLC | Home Health | 1022 Dumesnil St, Louisville, KY 40210-1517 | 2015-10-07 |
| 1831677319 | Teresa Lynn Marshall-bland | Counselor | 1218 W Oak St, Louisville, KY 40210-1533 | 2018-08-06 |
| Find all providers in zip 40210 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114530748 | Sol Dental Pllc | Clinic/Center | 1371 Hecla Dr Ste D2, Louisville, CO 80027-2318 | 2020-08-24 |
| 1144838970 | Superior Smiles, LLC | Clinic/Center | 16690 E Main St, Louisville, MS 39339-2750 | 2020-07-17 |
| 1629696505 | Kauffmann and Sims Dentistry Pllc | Clinic/Center | 3935 Dupont Cir Ste A, Louisville, KY 40207-4824 | 2020-07-08 |
| 1699394783 | Professional Dental Services of Kentucky Psc | Clinic/Center | 4814 Outer Loop Ste A, Louisville, KY 40219-3302 | 2020-04-09 |
| 1316579279 | Shannon P Johnson Dmd Pllc | Clinic/Center | 9510 Ormsby Station Rd Ste 203, Louisville, KY 40223-4083 | 2020-02-09 |
| 1306306253 | Tds Ky Two | Clinic/Center | 5141 Dixie Hwy Ste 101, Louisville, KY 40216-1765 | 2019-03-25 |
| 1669937058 | Hometown Family Dental | Clinic/Center | 4122 Shelbyville Rd Ste C, Louisville, KY 40207-3212 | 2019-02-10 |
| 1447714944 | Cobalt Dental Care, LLC | Clinic/Center | 225 S Hurstbourne Pkwy Ste 102, Louisville, KY 40222-4929 | 2019-01-29 |
| 1285129882 | Combs Family Dentistry | Clinic/Center | 2300 Terra Crossing Blvd Ste 108, Louisville, KY 40245-5906 | 2018-06-26 |
| 1972097277 | D & D Dental Enterprises | Clinic/Center | 6790 Dixie Hwy, Louisville, KY 40258 | 2018-06-20 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40210 |
Please comment or provide details below to improve the information on DIXIE DENTAL CENTER PSC.
| 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.