NPIMap

Organization Active NPI

Dental Professionals of Indiana, P.C.

  • General Practice Dentistry
  • Griffith, IN
National Provider Identifier
1306058417
Registry record updated Feb 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF INDIANA, P.C.
Practice address
1515 W 45TH Ave
Griffith, IN 46319
Phone
(219) 922-9007
Fax
(219) 922-3890
NPI assigned
May 3, 2007
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF INDIANA, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 5, 2014

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

Authorized official

Name
Jennifer Hoelscher
Title
Insurance/Credentialing
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1515 W 45TH Ave
Griffith, IN 46319

Mailing address

1515 W 45TH Ave
Griffith, IN 46319
Phone (219) 922-9007

Other names 1

  • Parkside Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of Indiana PC48 organizations share this tax ID, including this one
Part of
Heartland Dental Care of Indiana PC

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

View all 47

Locations

1515 W Glen Park Ave
Griffith, IN 46319
Phone (219) 922-9007

Practitioners & affiliated clinicians

Practitioners 5

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": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391558400000",
    "number": "1306058417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 W 45TH AVE",
            "city": "GRIFFITH",
            "state": "IN",
            "postal_code": "46319",
            "telephone_number": "219-922-9007",
            "fax_number": "219-922-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 W 45TH AVE",
            "city": "GRIFFITH",
            "state": "IN",
            "postal_code": "46319",
            "telephone_number": "219-922-9007",
            "fax_number": "219-922-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF INDIANA, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF INDIANA, P.C.",
        "enumeration_date": "2007-05-03",
        "last_updated": "2014-02-05",
        "status": "A",
        "authorized_official_last_name": "HOELSCHER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "INSURANCE/CREDENTIALING",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "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": "Parkside Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Griffith, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; 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.