Ireland Park Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12011066A Issued in IN

Legal business name

IRELAND PARK DENTISTRY

Practice address

1902 E Ireland Rd
South Bend, IN 46614-2863

Phone

(574) 291-8022

Fax

(574) 291-7868

NPI assigned

Mar 6, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Avis L Barker, DMD

Title

Partner

Phone

(574) 291-8022

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• David Allan Varner, D.D.S.

  • Dentist
  • South Bend, IN
  • NPI 1730480898
  NPD (past)
• Samantha Plank, DMD

  • General Practice Dentistry
  • Niles, MI
  • NPI 1033993944
  NPD (past)

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488758400000",
    "number": "1194265553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 E IRELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142863",
            "telephone_number": "574-291-8022",
            "fax_number": "574-291-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 E IRELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142863",
            "telephone_number": "574-291-8022",
            "fax_number": "574-291-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRELAND PARK DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-06",
        "last_updated": "2017-03-06",
        "status": "A",
        "authorized_official_last_name": "BARKER",
        "authorized_official_first_name": "AVIS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "574-291-8022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011066A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Morgan Irion, M.D.
• Randi Irwin, MA, LMHC
• David J Isaacson, MD
• Melyse Blandine Ishimwe
• Chloe Itimu

• General Practice Dentistry in South Bend, IN
• Providers in South Bend, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; 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.