Individual provider Active NPI

Vruti Pravin Sicinski, DDS

  • General Practice Dentistry
  • La Porte, IN
National Provider Identifier
1235747288
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12013409A Issued in IN
Practice address
910 I St
La Porte, IN 46350-5533
Phone
(219) 325-0202
NPI assigned
Jul 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12013409A IN Primary

Addresses

Primary practice location

910 I St
La Porte, IN 46350-5533

Mailing address

1120 Mossy LN
Mishawaka, IN 46544-9054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12013409AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Springer Dental Care at Keystone LLC CurrentSince Oct 12, 2025 Accepting new patients

Locations

3702 E Mishawaka Rd
Elkhart, IN 46517
Phone (574) 875-6595

1802 Charlton Ct
Goshen, IN 46526
Phone (574) 533-5925

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1235747288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 MOSSY LN",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465449054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 I ST",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463505533",
            "telephone_number": "219-325-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICINSKI",
        "first_name": "VRUTI",
        "middle_name": "PRAVIN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-15",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12013409A",
            "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 Apr 3, 2026; 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.