OrganizationActive
East Louisville Oral Surgery and Dental Implants PLC
NPI 1275292377 · Oral and Maxillofacial Surgery (Dentist) · Louisville, KY
Provider details
- NPI number
- 1275292377
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Organization subpart
- No
- Authorized official
- Kenneth Livesay, Member(502) 897-5282
Specialties & taxonomies
Dental Providers
- Oral & Maxillofacial Surgery (D.M.D.)204E00000X
Allopathic & Osteopathic Physicians
Practice location
1013 N Dupont Sq Ste B
Louisville, KY 40207-4612
Phone: (502) 897-5282
Fax: (502) 896-6714
Approximate (ZIP-level) locationGet directions
Mailing address
1013 N Dupont Sq Ste B
Louisville, KY 40207-4612
Additional practice locations (2)
- 4181 New Shepherdsville RdBardstown, KY 40004-9021Phone: (502) 305-3649Fax: (502) 373-6562
- 300 Middletown Park Pl Ste aLouisville, KY 40243-2541Phone: (502) 254-3818Fax: (502) 254-3819
Registry dates
- Enumerated
- 2021-12-16
- Last updated
- 2023-08-14
- Certified
- 2023-07-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.