NPIMap

Organization Active NPI

Wolf Family Dentistry, PC.

  • General Practice Dentistry
  • La Porte, IN
National Provider Identifier
1174656342
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12008861 Issued in IN
Legal business name
WOLF FAMILY DENTISTRY, PC.
Practice address
3550 W Johnson Rd
La Porte, IN 46350-8576
Phone
(219) 362-3730
Fax
(219) 324-4273
NPI assigned
Mar 14, 2007
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. Renee Ostermiller Wolf, D.D.S.NPI 1902099419
Title
Dentist
Phone
(219) 362-3730

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 12008861 IN Primary

Addresses

Primary practice location

3550 W Johnson Rd
La Porte, IN 46350-8576

Mailing address

3550 W Johnson Rd
La Porte, IN 46350-8576
Phone (219) 362-3730

National Provider Directory

National Provider Directory

Locations

3550 W Johnson Rd
La Porte, IN 46350
Phone (219) 362-3730

Practitioners & affiliated clinicians

Practitioners 2

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": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174656342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 W JOHNSON RD",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463508576",
            "telephone_number": "219-362-3730",
            "fax_number": "219-324-4273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 W JOHNSON RD",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463508576",
            "telephone_number": "219-362-3730",
            "fax_number": "219-324-4273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLF FAMILY DENTISTRY, PC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "OSTERMILLER",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "219-362-3730",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Porte, 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.