Kentuckiana Oral & Maxillofacial Surgery Assoc Psc
NPI 1396737011 · Oral and Maxillofacial Surgery (Dentist) · Louisville, KY
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kentuckiana Oral & Maxillofacial Surgery Assoc Psc is a Oral and Maxillofacial Surgery (Dentist) organization in Louisville, KY (NPI 1396737011).
Provider details
- NPI number
- 1396737011
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Organization subpart
- No
- Authorized official
- Nathan Walters, President(502) 454-4885
Specialties & taxonomies
Dental Providers
- Dentist122300000X
Dental Providers
- Oral & Maxillofacial Surgery (D.M.D.)204E00000X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 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
Mailing address
Registry dates
- Enumerated
- 2005-08-18
- Last updated
- 2018-02-06
Frequently asked questions
- What is Kentuckiana Oral & Maxillofacial Surgery Assoc Psc's NPI number?
- Kentuckiana Oral & Maxillofacial Surgery Assoc Psc's National Provider Identifier (NPI) is 1396737011, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kentuckiana Oral & Maxillofacial Surgery Assoc Psc?
- Kentuckiana Oral & Maxillofacial Surgery Assoc Psc is classified in the NPPES registry as Oral and Maxillofacial Surgery (Dentist) (Dental Providers).
- Where is Kentuckiana Oral & Maxillofacial Surgery Assoc Psc located?
- Kentuckiana Oral & Maxillofacial Surgery Assoc Psc's practice location on file with NPPES is 2800 Cannons Ln, Louisville, KY 40205.
- What is Kentuckiana Oral & Maxillofacial Surgery Assoc Psc's phone number?
- The practice phone number listed in the NPPES registry for Kentuckiana Oral & Maxillofacial Surgery Assoc Psc is (502) 454-4885.
- Does Kentuckiana Oral & Maxillofacial Surgery Assoc Psc accept Medicare?
- Kentuckiana Oral & Maxillofacial Surgery Assoc Psc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Kentuckiana Oral & Maxillofacial Surgery Assoc Psc?
- The authorized official listed on Kentuckiana Oral & Maxillofacial Surgery Assoc Psc's NPPES record is Nathan Walters, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kentuckiana Oral & Maxillofacial Surgery Assoc Psc's NPI active?
- Yes — Kentuckiana Oral & Maxillofacial Surgery Assoc Psc's NPI (1396737011) is active in the NPPES registry as of the last update on 2018-02-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.