NPIMap

Organization Active NPI

Lifetime Dental Care of Indiana, PC

  • General Practice Dentistry
  • Camby, IN
National Provider Identifier
1093937682
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LIFETIME DENTAL CARE OF INDIANA, PC
Practice address
8190 Windfall Lane
Suite B
Camby, IN 46113
Phone
(317) 821-0600
Fax
(317) 821-0606
NPI assigned
May 3, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Amy Kroeger
Title
Ins Cood
Phone
(217) 540-5100

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory
Tax ID family
Lifetime Dental Careof Indiana PC24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

Locations

8190 Windfall Ln
Ste B
Camby, IN 46113
Phone (317) 821-0600

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

8190 Windfall Lane
Suite B
Camby, IN 46113

Mailing address

8190 Windfall Lane
Suite B
Camby, IN 46113
Phone (317) 821-0600

Other names 1

NPPES NPI Registry
  • Camby Family Dentistry Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093937682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8190 WINDFALL LANE",
            "address_2": "SUITE B",
            "city": "CAMBY",
            "state": "IN",
            "postal_code": "46113",
            "telephone_number": "317-821-0600",
            "fax_number": "317-821-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8190 WINDFALL LANE",
            "address_2": "SUITE B",
            "city": "CAMBY",
            "state": "IN",
            "postal_code": "46113",
            "telephone_number": "317-821-0600",
            "fax_number": "317-821-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME DENTAL CARE OF INDIANA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KROEGER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "INS COOD",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camby Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Camby, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.