Access Dental of Terre Haute LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ACCESS DENTAL OF TERRE HAUTE LLC

Practice address

3359 S US Highway 41
Terre Haute, IN 47802

Phone

(812) 645-4110

NPI assigned

Dec 10, 2021

Last updated

Dec 10, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Andrea Carrillo

Title

Regional Director

Phone

(512) 351-2612

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1639094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639094400000",
    "number": "1013676675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3359 S US HIGHWAY 41",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "47802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3359 S US HIGHWAY 41",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "47802",
            "telephone_number": "812-645-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS DENTAL OF TERRE HAUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-10",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-09",
        "status": "A",
        "authorized_official_last_name": "CARRILLO",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR",
        "authorized_official_telephone_number": "512-351-2612"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.