Indiana Dental Sleep Therapy LLC

Primary specialty

DentistTaxonomy code 122300000X

License

12011052A Issued in IN

Legal business name

INDIANA DENTAL SLEEP THERAPY LLC

Practice address

4921 Sr 26 E
Suite 300
Lafayette, IN 47905

Phone

(309) 243-8980

NPI assigned

Aug 28, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Shane Cope, DDS, MSD

Title

Owner

Phone

(317) 640-7907

Specialties & licenses 1

Addresses

Other names 1

• Koala Center for Sleep Disorders IN-2 Doing business as

Locations

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

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463356800000",
    "number": "1134596869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4921 SR 26 E",
            "address_2": "SUITE 300",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 SR 26 E",
            "address_2": "SUITE 300",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47905",
            "telephone_number": "309-243-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA DENTAL SLEEP THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-28",
        "last_updated": "2016-05-16",
        "status": "A",
        "authorized_official_last_name": "COPE",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-640-7907",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MSD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011052A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Koala Center for Sleep Disorders IN-2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; 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.