# BLINCOE & SHUTT PSC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306220140
- **Authorized official:** DR. GLENN R. BLINCOE DMD (PRESIDENT)
- **Authorized official phone:** (502) 895-2210

## Contact information

- **Practice address:** 4122 SHELBYVILLE RD STE 115, LOUISVILLE, KY 40207-3206
- **Practice address phone:** (502) 895-2210
- **Practice address fax:** (502) 895-0425
- **Mailing address:** 4122 SHELBYVILLE RD STE 115, LOUISVILLE, KY 40207-3206
- **Mailing address phone:** (502) 895-2210

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |

## Other

- **Enumeration date:** 07/10/2015
- **Last updated:** 02/04/2025