OrganizationActive
Community Care of Kentucky, Inc
NPI 1053799080 · General Practice Dentistry · Madisonville, KY
Provider details
- NPI number
- 1053799080
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Jenell Stump, Manager, Licensing & Credentialing(629) 999-5006
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(74/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1175 S Main St Ste 4
Madisonville, KY 42431-3337
Phone: (270) 383-5511
Fax: (270) 821-9602
Street-level locationGet directions
Mailing address
Po Box 2369
Anniston, AL 36202-2369
Registry dates
- Enumerated
- 2015-05-11
- Last updated
- 2018-05-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.