Healthy Smiles Portage, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HEALTHY SMILES PORTAGE, LLC

Practice address

6280 W Main St
Portage, IN 46368-4670

Phone

(219) 938-2637

NPI assigned

Apr 5, 2019

Organization subpart

No

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

Authorized official

Name

Nicholas Cain

Title

Owner

Phone

(219) 938-2637

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554422400000",
    "number": "1306308515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4629 MELTON RD",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464032866",
            "telephone_number": "219-938-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6280 W MAIN ST",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463684670",
            "telephone_number": "219-938-2637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY SMILES PORTAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-05",
        "last_updated": "2019-04-05",
        "status": "A",
        "authorized_official_last_name": "CAIN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-938-2637"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Portage, IN
• Providers in Portage, 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 Apr 5, 2019; 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.