Larry Gordon Phillips in Louisville - Pediatric Dentistry
Larry Gordon Phillips - NPI 1366458960
Larry Gordon Phillips is a Pediatric Dentistry in Louisville, Kentucky. Larry Gordon Phillips practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Larry Gordon Phillips is 1366458960. The last update date is 2007-07-08.
Larry Gordon Phillips's current location address is 4514 Outer Loop, Louisville, Kentucky. You can contact this provider via phone number 5029699264 and fax number 5029699535. The mailing address for Larry Gordon Phillips is 4514 Outer Loop, Louisville, Kentucky. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Larry Gordon Phillips |
|---|---|
| Address | 4514 Outer Loop, Louisville, Kentucky |
| Phone Number | 5029699264 |
| Fax Number | 5029699535 |
| Sole Proprietor | Y |
| Credentials | D.M.D. |
NPI Number Detail
| NPI Number | 1366458960 |
|---|---|
| Provider Enumeration Date | 2006-08-01 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 4514 Outer Loop |
|---|---|
| City | Louisville |
| State | Kentucky (KY) |
| Post Code | 402193857 |
| Phone Number | 5029699264 |
| Fax Number | 5029699535 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 4510 |
|
Definition: 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. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 60045101 | KY | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Larry Gordon Phillips by the Centers for Medicare & Medicaid Services (CMS)?
The Larry Gordon Phillips has been assigned the NPI (National Provider Identifier) 1366458960. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the Larry Gordon Phillips located?
The Larry Gordon Phillips is located at 4514 Outer Loop, Louisville, KY 402193857.
What is the area of specialization for Larry Gordon Phillips, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Larry Gordon Phillips is Pediatric Dentistry, and the corresponding taxonomy code that categorizes this area of expertise is 1223P0221X.
On what date did the Centers for Medicare & Medicaid Services issue the 1366458960 to Larry Gordon Phillips?
The Larry Gordon Phillips received its 1366458960 assignment from the Centers for Medicare & Medicaid Services on 2006-08-01.
As of what date was the information pertaining to Larry Gordon Phillips, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Larry Gordon Phillips, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2007-07-08.
NPI Number: 1588667679
Address: 9104 Babcock Blvd, Pittsburgh, PA