Provider Demographics
NPI:1366150013
Name:JFD KY PLLC
Entity type:Organization
Organization Name:JFD KY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD TERRELL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:502-599-9543
Mailing Address - Street 1:9120 HURSTBOURNE LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-1627
Mailing Address - Country:US
Mailing Address - Phone:502-671-5087
Mailing Address - Fax:812-280-7184
Practice Address - Street 1:9120 HURSTBOURNE LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1627
Practice Address - Country:US
Practice Address - Phone:502-671-5087
Practice Address - Fax:812-280-7184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty