Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Modern Kids Dentistry of Louisville, PLLC

Organization Pediatric Dentistry · NPI 1104646983

Modern Kids Dentistry of Louisville, PLLC provides Pediatric Dentistry in Louisville, Kentucky. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

129 Evergreen Rd
Louisville, KY 40243-2426
Phone: (502) 245-8855
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X

Record details

NPI number1104646983
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Justin Raybould — Owner · (859) 321-7051
NPI enumeratedOctober 15, 2024
Last updated in NPPESOctober 15, 2024
Certification dateOctober 15, 2024
Mailing address129 Evergreen Rd, Louisville, KY 40243-2426

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