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MODERN KIDS DENTISTRY
NPI 1174912224
Dentist - Pediatric Dentistry in Lexington, KY

Active since January 13, 2015
4384 CLEARWATER WAY, SUITE 150, LEXINGTON, KY 40515(859) 321-7051 Get Directions Write a Review

NPPES record last updated: April 13, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Modern Kids Dentistry NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MODERN KIDS DENTISTRY (NPI 1174912224) is a healthcare organization registered as a pediatric dentistry in Lexington, Kentucky and active in the NPI registry since January 2015. The organization lists Justin Michael Raybould, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1174912224
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameMODERN KIDS DENTISTRY
Location Address4384 CLEARWATER WAY, SUITE 150Lexington, KY 40515-6477
Mailing Address725 Beechmont Rd, Suite 150Lexington, KY 40502-2837 · (859) 321-7051
Phone(859) 321-7051
Organization SubpartNo
Authorized OfficialJustin Michael RaybouldPresident/ceo · (859) 321-7051
Enumeration DateJanuary 13, 2015
Last NPPES UpdateApril 13, 2015
✔ NPI 1174912224 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in KY · 8732
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.
4384 CLEARWATER WAY, Lexington, KY 40515
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LEXINGTON CHILDREN'S DENTISTRY
Dentist (Pediatric Dentistry)
4384 CLEARWATER WAY, SUITE 150
LEXINGTON, KY 40515
Fayette County (859) 321-7048
DR. NICOLE FALLAHZADEH DMD
Dentist
4384 CLEARWATER WAY, STE 110
LEXINGTON, KY 40515
Fayette County (859) 913-4472
DR. JUSTIN MICHAEL RAYBOULD D.M.D.
Dentist (Pediatric Dentistry)
4384 CLEARWATER WAY, SUITE 150
LEXINGTON, KY 40515
Fayette County (859) 321-7051
VETERANS PARK FAMILY DENTISTRY PLLC
Dentist
4384 CLEARWATER WAY, STE 110
LEXINGTON, KY 40515
Fayette County (859) 272-0800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Modern Kids Dentistry's NPI number?

The NPI number for Modern Kids Dentistry is 1174912224. It was assigned to this organization in the NPPES registry on January 13, 2015.

Where is Modern Kids Dentistry located?

Modern Kids Dentistry is located at 4384 Clearwater Way Suite 150, Lexington, KY 40515. The listed phone number is (859) 321-7051.

What is Modern Kids Dentistry's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Modern Kids Dentistry was last updated on April 13, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.