Bloomfield Family Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BLOOMFIELD FAMILY DENTAL LLC

Practice address

200 E Main St Ste 3
Bloomfield, IN 47424-1452

Phone

(812) 384-3736

NPI assigned

Apr 30, 2024

Last updated

Apr 30, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Philip James Mirise, DDSNPI 1245319151

Title

Dentist

Phone

(317) 670-6026

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.

• Philip James Mirise, DDS

  • General Practice Dentistry
  • Franklin, IN
  • NPI 1245319151
  NPD Authorized official
• James C Vandeventer, DDS

  • General Practice Dentistry
  • Bloomfield, IN
  • NPI 1952523094
  NPD (past)

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

{
    "created_epoch": "1714435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1275389181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 W COUNTY ROAD 100 N",
            "city": "BARGERSVILLE",
            "state": "IN",
            "postal_code": "461069582",
            "telephone_number": "317-670-6026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E MAIN ST STE 3",
            "city": "BLOOMFIELD",
            "state": "IN",
            "postal_code": "474241452",
            "telephone_number": "812-384-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMFIELD FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-30",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "MIRISE",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "317-670-6026",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Suzanne Bailey, MS, ED.S.
• Robert Douglas Baize, CDP, NCAC I, MHP,
• Melissa Jean Banther
• Katey Baruth, PHD, HSPP
• Owen Albert Batterton, MD
• Bloomfield School District
• Aaron W Brown, PHARMD
• Burton Chiropractic Clinic
• Franklin Wayne Burton, D.C.
• Corey Busk, CAPRC-1

• Dental Clinic/Center in Bloomfield, IN
• Providers in Bloomfield, IN by specialty
• Dental Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.