Edward Charles Collins III, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12012076A Issued in IN

Practice address

3367 Douglas Rd
South Bend, IN 46635-1779

Phone

(574) 272-8823

Fax

(574) 277-1837

NPI assigned

Apr 6, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: ecollins1158750@direct.trinity-health.org

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

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1235454950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 E DAY RD",
            "address_2": "SUITE 260",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453444",
            "telephone_number": "574-272-8823",
            "fax_number": "574-277-1837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3367 DOUGLAS RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351779",
            "telephone_number": "574-272-8823",
            "fax_number": "574-277-1837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "EDWARD",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-06",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12012076A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201225610",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Coleman, RBT
• Randy Coleman
• Toikesia Coleman, LSW
• Julie Collier, RPH
• Arielle Collins, RBT
• Heidi A Collins, MD
• Chantelle Collum
• Jillian R Colpitts, FNP
• Tasha Colpitts
• Joseph M Coman II, S.P.

• Oral and Maxillofacial Surgery (Dentist) in South Bend, IN
• Providers in South Bend, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.