NPIMap

Organization Active NPI

State Street Dentistry PC

  • Dentist
  • Newburgh, IN
National Provider Identifier
1205114147
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12006732 Issued in IN
Legal business name
STATE STREET DENTISTRY PC
Practice address
333C State St
Newburgh, IN 47630-1231
Phone
(812) 853-3344
Fax
(812) 853-3370
NPI assigned
Jul 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

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

Authorized official

Name
Ms. Natalie Marie Klump
Title
General Manager
Phone
(812) 431-2201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 12006732 IN Primary

Addresses

Primary practice location

333C State St
Newburgh, IN 47630-1231

Mailing address

333C State St
Newburgh, IN 47630-1231
Phone (812) 853-3344

National Provider Directory

National Provider Directory

Locations

333 State St
Ste C
Newburgh, IN 47630
Phone (812) 853-3344

NPI Registry JSON

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

{
    "created_epoch": "1311638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311638400000",
    "number": "1205114147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333C STATE ST",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476301231",
            "telephone_number": "812-853-3344",
            "fax_number": "812-853-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333C STATE ST",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476301231",
            "telephone_number": "812-853-3344",
            "fax_number": "812-853-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE STREET DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-26",
        "last_updated": "2011-07-26",
        "status": "A",
        "authorized_official_last_name": "KLUMP",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "812-431-2201",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12006732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; 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.