Organization Active NPI

Sycamore Hills Dentistry

  • General Practice Dentistry
  • Fort Wayne, IN
National Provider Identifier
1295357481
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SYCAMORE HILLS DENTISTRY
Practice address
10082 Illinois Rd
Fort Wayne, IN 46804-5772
Phone
(260) 213-4400
NPI assigned
May 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2020

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

Authorized official

Name
Tina Pressnall
Title
Practice Consultant
Phone
(317) 426-9876

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

10082 Illinois Rd
Fort Wayne, IN 46804-5772

Mailing address

10082 Illinois Rd
Fort Wayne, IN 46804-5772
Phone (260) 213-4400

National Provider Directory

National Provider Directory

Locations

10082 Illinois Rd
Fort Wayne, IN 46804
Phone (260) 213-4400

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589155200000",
    "number": "1295357481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10082 ILLINOIS RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468045772",
            "telephone_number": "260-213-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10082 ILLINOIS RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468045772",
            "telephone_number": "260-213-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYCAMORE HILLS DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-11",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A",
        "authorized_official_last_name": "PRESSNALL",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "PRACTICE CONSULTANT",
        "authorized_official_telephone_number": "317-426-9876"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.