NPIMap

Organization Active NPI

MKD Dental Group

Doing business as Grabill Family Dentistry

  • General Practice Dentistry
  • Grabill, IN
National Provider Identifier
1164786133
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MKD DENTAL GROUP
Doing business as
Grabill Family Dentistry
Practice address
13307 Witmer Rd
Grabill, IN 46741-9636
Phone
(260) 627-1211
Fax
(260) 627-1277
NPI assigned
Jun 25, 2012
Last updated
Aug 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Authorized official

Name
Dr. Matthew Steven Kolkman, DDSNPI 1255693396
Title
Owner/Dentist
Phone
(260) 627-1211

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

13307 Witmer Rd
Grabill, IN 46741-9636

Mailing address

13307 Witmer Rd
Grabill, IN 46741-9636
Phone (260) 627-1211

Other names 1

  • Grabill Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

13307 Witmer Rd
Grabill, IN 46741
Phone (260) 627-1121

Practitioners & affiliated clinicians

Practitioners 3

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": "1340582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1164786133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13307 WITMER RD",
            "city": "GRABILL",
            "state": "IN",
            "postal_code": "467419636",
            "telephone_number": "260-627-1211",
            "fax_number": "260-627-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13307 WITMER RD",
            "city": "GRABILL",
            "state": "IN",
            "postal_code": "467419636",
            "telephone_number": "260-627-1211",
            "fax_number": "260-627-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MKD DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-25",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "KOLKMAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "260-627-1211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grabill Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grabill, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.