NPIMap

Organization Active NPI

Monrovia Dental Clinic, LLC

  • Dental Clinic/Center
  • Monrovia, IN
National Provider Identifier
1134401144
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
12011298A Issued in IN
Legal business name
MONROVIA DENTAL CLINIC, LLC
Practice address
253 W Main St
Monrovia, IN 46157-9567
Phone
(317) 996-3391
NPI assigned
Sep 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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

Authorized official

Name
Dr. Mark Sanford, DDSNPI 1447487392
Title
Member
Phone
(317) 996-3391

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
Dental Clinic/Center 261QD0000X 12011298A IN Primary

Addresses

Primary practice location

253 W Main St
Monrovia, IN 46157-9567

Mailing address

253 W Main St
Monrovia, IN 46157-9567

National Provider Directory

National Provider Directory

Locations

253 W Main St
Monrovia, IN 46157
Phone (317) 996-3391

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": "1316044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316044800000",
    "number": "1134401144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 W MAIN ST",
            "city": "MONROVIA",
            "state": "IN",
            "postal_code": "461579567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 W MAIN ST",
            "city": "MONROVIA",
            "state": "IN",
            "postal_code": "461579567",
            "telephone_number": "317-996-3391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONROVIA DENTAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-15",
        "last_updated": "2011-09-15",
        "status": "A",
        "authorized_official_last_name": "SANFORD",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "317-996-3391",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IN",
            "license": "12011298A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monrovia, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; 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.