Organization Active NPI

Covenant Family Dental Care

  • General Practice Dentistry
  • Salina, KS
National Provider Identifier
1053758284
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COVENANT FAMILY DENTAL CARE
Practice address
611 E Iron Ave
Salina, KS 67401-3035
Phone
(785) 404-6333
NPI assigned
May 29, 2013
Last updated
May 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2013

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

Authorized official

Name
Dr. Vermelle Lonnisha Brown-Ghoston, DDS
Title
Owner
Phone
(785) 250-6939

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X KS Primary

Addresses

Primary practice location

611 E Iron Ave
Salina, KS 67401-3035

Mailing address

4428 SW Wanamaker Rd
Topeka, KS 66610-1340
Phone (785) 250-6939

Other identifiers 1

IdentifierTypeStateIssuer
200383300AMedicaidKS

National Provider Directory

National Provider Directory

Locations

611 E Iron Ave
Salina, KS 67401
Phone (785) 404-6333

Practitioners & affiliated clinicians

Practitioners 1

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": "1369785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369785600000",
    "number": "1053758284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4428 SW WANAMAKER RD",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666101340",
            "telephone_number": "785-250-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E IRON AVE",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674013035",
            "telephone_number": "785-404-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT FAMILY DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-29",
        "last_updated": "2013-05-29",
        "status": "A",
        "authorized_official_last_name": "BROWN-GHOSTON",
        "authorized_official_first_name": "VERMELLE",
        "authorized_official_middle_name": "LONNISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "785-250-6939",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200383300A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salina, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.