Prime Dental Care LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PRIME DENTAL CARE LLC

Practice address

435 W Coliseum Blvd
Fort Wayne, IN 46805-1010

Phone

(260) 263-6200

NPI assigned

Sep 18, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Vijay Kumar Godi, DDS

Title

Dentist

Phone

(419) 788-5803

Specialties & licenses 1

Addresses

Other names 1

• PRIME DENTAL Doing business as

Locations

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1053199539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 TROUTWOOD DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468188791",
            "telephone_number": "419-788-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 W COLISEUM BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468051010",
            "telephone_number": "260-263-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-17",
        "status": "A",
        "authorized_official_last_name": "GODI",
        "authorized_official_first_name": "VIJAY KUMAR",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "419-788-5803",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIME DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nichol K. Price, FNP-C
• Steven L Price, MD
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• Prime Care Adult Day & Wellness Center LLC
• Prime Care Behavioral Health and Wellness, LLC
• Amy Prince
• Priority Endodontics LLC
• John C. Pritchard, MD
• Hayden A Privett
• Pro Resources Inc.

• General Practice Dentistry in Fort Wayne, IN
• Providers in Fort Wayne, 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 Sep 18, 2023; 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.