NPIMap

Organization Active NPI

Main Street Family Dentistry

  • General Practice Dentistry
  • Plainfield, IN
National Provider Identifier
1104990233
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12009821 Issued in IN
Legal business name
MAIN STREET FAMILY DENTISTRY
Practice address
712 W Main Street
Suite 100
Plainfield, IN 46168-9403
Phone
(317) 839-5550
Fax
(317) 839-5509
NPI assigned
Nov 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Doris Ann Vannatter, DDSNPI 1750414777
Title
President Owner
Phone
(317) 839-5500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 12009821 IN Primary

Addresses

Primary practice location

712 W Main Street
Suite 100
Plainfield, IN 46168-9403

Mailing address

712 W Main Street
Suite 100
Plainfield, IN 46168-9403
Phone (317) 839-5550

National Provider Directory

National Provider Directory

Locations

712 W Main St
Ste 100
Plainfield, IN 46168
Phone (317) 839-5550

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104990233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 W MAIN STREET",
            "address_2": "SUITE 100",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461689403",
            "telephone_number": "317-839-5550",
            "fax_number": "317-839-5509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 W MAIN STREET",
            "address_2": "SUITE 100",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461689403",
            "telephone_number": "317-839-5550",
            "fax_number": "317-839-5509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VANNATTER",
        "authorized_official_first_name": "DORIS",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "317-839-5500",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, 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.