NPIMap

Organization Active NPI

Dental Health Associates of Indiana

  • General Practice Dentistry
  • Bloomington, IN
National Provider Identifier
1174693220
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL HEALTH ASSOCIATES OF INDIANA
Practice address
1121 W 2ND St
Bloomington, IN 47403-2160
Phone
(812) 339-1671
Fax
(812) 337-1231
NPI assigned
Nov 8, 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
Mr. Tim Hoagland
Title
Executive
Phone
(502) 423-9111

Specialties & licenses 1

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

Addresses

Primary practice location

1121 W 2ND St
Bloomington, IN 47403-2160

Mailing address

9505 Williamsburg PLZ Ste 301
Louisville, KY 40222-5090

Other names 1

  • Bloomington Gentle Dentist Other name

National Provider Directory

National Provider Directory
Tax ID family
Dental Health Assoc of in13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1121 W 2nd St
Bloomington, IN 47403
Phone (812) 336-2225

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174693220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9505 WILLIAMSBURG PLZ STE 301",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402225090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 W 2ND ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032160",
            "telephone_number": "812-339-1671",
            "fax_number": "812-337-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL HEALTH ASSOCIATES OF INDIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOAGLAND",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "EXECUTIVE",
        "authorized_official_telephone_number": "502-423-9111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bloomington Gentle Dentist",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bloomington, 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.