Highland Creek Family Dental - South LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HIGHLAND CREEK FAMILY DENTAL - SOUTH LLC

Practice address

3209 Builder Dr Ste 130
Lafayette, IN 47909-4054

Phone

(765) 204-1676

NPI assigned

Oct 24, 2022

Organization subpart

No

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

Authorized official

Name

Jenny Garcia-Rocha

Title

Credentialing Lead

Phone

(972) 869-3789

Specialties & licenses 1

Addresses

Other names 1

• HIghland Creek Family Dental - South Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sangita Buda, DMD

  • Dentist
  • Lafayette, IN
  • NPI 1326751702
  NPD
• Han NA Park, DDS

  • Dentist
  • Lafayette, IN
  • NPI 1083341390
  NPD
• Noah David Barrett, D.D.S.

  • Dentist
  • Logansport, IN
  • NPI 1821781220

  General Practice

  NPD (past)

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666569600000",
    "number": "1245957950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3209 BUILDER DR STE 130",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479094054",
            "telephone_number": "765-204-1676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 BUILDER DR STE 130",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479094054",
            "telephone_number": "765-204-1676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND CREEK FAMILY DENTAL - SOUTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A",
        "authorized_official_last_name": "GARCIA-ROCHA",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "CREDENTIALING LEAD",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HIghland Creek Family Dental - South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tesa Danielle Hickman, MA, BCBA
• Jasmin Higareda
• Gregory Higbee, LCAC
• Marideth Higgins
• Michael Edgar Highhouse, MD
• Jon Jacob Hiles, PHARMD, BCPS
• Delthea J Hill, PHD
• Faihza M Hill, MD, MPH, MS
• Page Hill
• Tiffany Hill, RBT

• General Practice Dentistry in Lafayette, IN
• Providers in Lafayette, 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 Oct 24, 2022; 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.