Kentucky Oral and Facial Surgery
NPI 1790575736ActiveOrganization· Dentist, Oral and Maxillofacial Surgery· Louisville, KY
Dentist, Oral and Maxillofacial Surgery in Louisville, Kentucky, registered in NPPES in May 2025. The authorized official on file is Jackie Holloway, Director Of Rcm.
Overview
| NPI | 1790575736 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 12, 2025 |
| Last updated in NPPES | May 20, 2025 |
| Certified by provider | May 20, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Oral and Maxillofacial Surgery Primary | 1223S0112X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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