Organization Active NPI

Royale Family Dentistry

  • General Practice Dentistry
  • Muncie, IN
National Provider Identifier
1174530950
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1200-9865 Issued in IN
Legal business name
ROYALE FAMILY DENTISTRY
Practice address
1804 W Royale Dr
Muncie, IN 47304-2243
Phone
(765) 289-1578
Fax
(765) 289-7901
NPI assigned
Aug 2, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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
Dr. Jeanine Marie Green, D.D.S.
Title
Owner
Phone
(765) 289-1578

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 1200-9865 IN Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 1200-6019 IN

Addresses

Primary practice location

1804 W Royale Dr
Muncie, IN 47304-2243

Mailing address

1804 W Royale Dr
Muncie, IN 47304-2243
Phone (765) 289-1578

National Provider Directory

National Provider Directory

Locations

1804 W Royale Dr
Muncie, IN 47304
Phone (765) 289-1578

Practitioners & affiliated clinicians

Practitioners 1

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": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174530950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 W ROYALE DR",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473042243",
            "telephone_number": "765-289-1578",
            "fax_number": "765-289-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 W ROYALE DR",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473042243",
            "telephone_number": "765-289-1578",
            "fax_number": "765-289-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROYALE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JEANINE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-289-1578",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "1200-9865",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "1200-6019",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, 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.