KENTUCKY05
NPI 1194103127
Dentist - General Practice in Louisville, KY

Q: What is the provider's specialty?

The provider's specialty is Dentist with taxonomy code 1223G0001X and a focus in General Practice.

Active since May 11, 2015

3438 TAYLOR BLVD, LOUISVILLE, KY 40215(502) 366-4442(502) 366-4446 Get Directions Write a Review

NPPES record last updated: May 11, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Kentucky05 NPPES

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

KENTUCKY05 (NPI 1194103127) is a healthcare organization registered as a general practice in Louisville, Kentucky and active in the NPI registry since May 2015. The organization lists Mandy Holland, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1194103127

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameCOMMUNITY CARE OF KENTUCKY, INC

Location Address3438 TAYLOR BLVDLouisville, KY 40215-2648

Mailing AddressPo Box 2369Anniston, AL 36202-2369 · (256) 241-3965 · Fax (256) 241-1698

Phone(502) 366-4442

Fax(502) 366-4446

Organization SubpartYes

Authorized OfficialMandy HollandCredentialing Manager · (256) 504-3326

Enumeration DateMay 11, 2015

✔ NPI 1194103127 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

3438 TAYLOR BLVD, Louisville, KY 40215

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Other Names 1

Other NameKentucky05

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