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DENTAL SURGICENTER OF LOUISVILLE LLC
NPI 1255846770
Anesthesiology in Louisville, KY

Active since December 06, 2017CLIA 18D2116953 · Waiver
2800 CANNONS LN STE 100, LOUISVILLE, KY 40205(502) 813-8604(502) 813-8612 Get Directions Write a Review

NPPES record last updated: January 30, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 30, 2026, Jan 21, 2026, Oct 4, 2022 and 2 more (5 updates tracked since 2017).

About Dental Surgicenter Of Louisville Llc NPPES

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

DENTAL SURGICENTER OF LOUISVILLE LLC (NPI 1255846770) is a healthcare organization registered as an anesthesiology in Louisville, Kentucky and active in the NPI registry since December 2017. The organization holds a CLIA Waiver certificate valid through August 4, 2028 and lists Devin Larsen, Ceo, as its authorized official.

NPPES Registry Identity

NPI1255846770
Entity TypeOrganization
Primary Taxonomy207L00000X
Legal Business NameDENTAL SURGICENTER OF LOUISVILLE LLC
Location Address2800 CANNONS LN STE 100Louisville, KY 40205-2173
Mailing Address9709 Lakeside Blvd Ste 350Spring, TX 77381-1216 · (713) 489-2198 · Fax (713) 489-2978
Phone(502) 813-8604
Fax(502) 813-8612
Organization SubpartNo
Authorized OfficialDevin LarsenCeo · (717) 489-2198
Enumeration DateDecember 6, 2017
Last NPPES UpdateJanuary 30, 20265 updates tracked since enumeration
NPPES CertifiedJanuary 30, 2026
✔ NPI 1255846770 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
2800 CANNONS LN STE 100, Louisville, KY 40205
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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dental Surgicenter Of Louisville Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Dental Surgicenter Of Louisville LLC, which bills Medicare for the services they deliver. Of these, 6 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

George Isaacs, MD
Anesthesiology
NPI 1619960622
4000 KRESGE WAY
Louisville, KY 40207
(502) 259-5391
✔ PECOS✔ Accepts Medicare1.1 mi
Timothy Heine, MD
Anesthesiology
NPI 1073569323
320 WHITTINGTON PKWY SUITE 301
Louisville, KY 40222
(502) 625-5584
✔ PECOS✔ Accepts Medicare4.1 mi
Robert Metz, M.D.
Anesthesiology
NPI 1073524724
614 E. CHESTNUT ST
Louisville, KY 40202
(502) 589-9488
✔ PECOS5.2 mi
Margo Vallee
Anesthesiology
NPI 1619185543
231 E CHESTNUT ST KOSAIR CHILDRENS HOSPITAL
Louisville, KY 40202
(502) 451-9949
✔ PECOS5.8 mi
Ross Cotton, MD
Anesthesiology
NPI 1144271644
11518 MAIN ST
Louisville, KY 40243
(270) 229-6402
✔ PECOS✔ Accepts Medicare6.1 mi
Edwin Render, M.D.
Anesthesiology
NPI 1457345191
1850 BLUEGRASS AVE
Louisville, KY 40215
(502) 852-5851
✔ PECOS✔ Accepts Medicare8.4 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 18D2116953

Dental Surgicenter Of Louisville, LLC · Louisville, KY
Active · expires Aug 4, 2028
CLIA Number18D2116953
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateAugust 5, 2026
Certificate Expiration DateAugust 4, 2028
Laboratory DirectorNathan Walters
Laboratory Phone(502) 813-8615
Laboratory LocationDental Surgicenter Of Louisville, LLC2800 Cannons Lane, Ste 100, Louisville, KY 40205
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Dental Surgicenter Of Louisville LLC's NPI number?

The NPI number for Dental Surgicenter Of Louisville LLC is 1255846770. It was assigned to this organization in the NPPES registry on December 6, 2017.

Where is Dental Surgicenter Of Louisville LLC located?

Dental Surgicenter Of Louisville LLC is located at 2800 Cannons Ln Ste 100, Louisville, KY 40205. The listed phone number is (502) 813-8604.

What is Dental Surgicenter Of Louisville LLC's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Dental Surgicenter Of Louisville LLC enrolled in Medicare?

Yes. Dental Surgicenter Of Louisville LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dental Surgicenter Of Louisville LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians, all in Anesthesiology, reassign their Medicare billing to Dental Surgicenter Of Louisville LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 6 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Dental Surgicenter Of Louisville LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D2116953) is associated with this NPI, valid through August 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Dental Surgicenter Of Louisville LLC accept?

Health plans from Anthem Blue Cross and Blue Shield and CareSource list Dental Surgicenter Of Louisville LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dental Surgicenter Of Louisville LLC was last updated on January 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.