Personalized Dental Center

Primary specialty

DentistTaxonomy code 122300000X

License

8590 Issued in IN

Legal business name

PERSONALIZED DENTAL CENTER

Practice address

1411 S Woodland Ave Ste F
Michigan City, IN 46360-7170

Phone

(219) 872-4151

NPI assigned

Apr 29, 2009

Organization subpart

No

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

Authorized official

Name

Cindy Kirby, DDS

Title

Owner

Phone

(219) 678-0485

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240963200000",
    "number": "1306080734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 S WOODLAND AVE STE F",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607170",
            "telephone_number": "219-872-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 S WOODLAND AVE STE F",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607170",
            "telephone_number": "219-872-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONALIZED DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-29",
        "last_updated": "2009-04-29",
        "status": "A",
        "authorized_official_last_name": "KIRBY",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-678-0485",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "8590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Pellar, RN, CNS-BC
• Nikole Pennington, FNP-BC
• Molly Perales, ATC
• Irma Perez, COTA
• Personal Caregivers of Michiana, Inc.
• David Eugene Peters, DDS
• Luciana Marie Petitti, O.D.
• Kimberly Kaye Pflughaupt, FNP
• Pharma-Card East, Inc.
• Valerie Pickford, DPT

• Dentist in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2009; 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.