NPIMap

Organization Active NPI

Dental Professionals of Indiana, P.C.

Doing business as Evansville Family Dentistry

  • General Practice Dentistry
  • Evansville, IN
National Provider Identifier
1043432552
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF INDIANA, P.C.
Doing business as
Evansville Family Dentistry
Practice address
2820 N Green River Rd
Evansville, IN 47715-1414
Phone
(812) 473-1400
Fax
(812) 473-6096
NPI assigned
May 3, 2007
Last updated
Mar 7, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF INDIANA, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Authorized official

Name
Hillary Thull
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

2820 N Green River Rd
Evansville, IN 47715-1414

Mailing address

2820 N Green River Rd
Evansville, IN 47715-1414
Phone (812) 473-1400

Other names 1

  • Evansville Family Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Indiana PC48 organizations share this tax ID, including this one
Part of
Dental Professionals of Indiana PC

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

View all 47

Locations

1220 Washington Ave
Evansville, IN 47714
Phone (812) 473-1400

2820 N Green River Rd
Evansville, IN 47715
Phone (812) 473-1400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1043432552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 N GREEN RIVER RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477151414",
            "telephone_number": "812-473-1400",
            "fax_number": "812-473-6096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 N GREEN RIVER RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477151414",
            "telephone_number": "812-473-1400",
            "fax_number": "812-473-6096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF INDIANA, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF INDIANA, P.C.",
        "enumeration_date": "2007-05-03",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evansville Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.