Wabash Dental Services LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

IN12007971 Issued in IN

Legal business name

WABASH DENTAL SERVICES LLC

Practice address

278 Manchester Ave
Wabash, IN 46992-1808

Phone

(260) 563-4065

Fax

(260) 563-4193

NPI assigned

Jul 7, 2009

Last updated

Jul 7, 2009By 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. Mary Anne Bain, DDSNPI 1962508051

Title

Owner

Phone

(260) 563-4065

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Mary Anne Bain, DDS

  • General Practice Dentistry
  • Wabash, IN
  • NPI 1962508051
  Authorized official Same address or phone

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246924800000",
    "number": "1316176803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 MANCHESTER AVE",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469921808",
            "telephone_number": "260-563-4065",
            "fax_number": "260-563-4193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 MANCHESTER AVE",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469921808",
            "telephone_number": "260-563-4065",
            "fax_number": "260-563-4193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WABASH DENTAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-07",
        "last_updated": "2009-07-07",
        "status": "A",
        "authorized_official_last_name": "BAIN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-563-4065",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "IN12007971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1223G0001X",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wabash County Hospital, Inc. (Wabash Surgery Clinic)
• Wabash County Hospital, Inc. (Wabash Internal Medicine)
• Wabash County Hospital, Inc. (Wabash Orthopedic Center)
• Wabash County Hospital, Inc. (Wabash Family Medicine)
• Wabash County Hospital, Inc. (Family Physicians Associated)
• Wabash Recovery Services Inc. Dba: Waypoint
• Wabash Senior Opco, LLC (1019 Belles Place Wabash)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1667)
• Wal-Mart Stores East, LP (Walmart Vision Center 30-1667)
• Walgreen Co (Walgreens #9689)

• General Practice Dentistry in Wabash, IN
• Providers in Wabash, 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 Jul 7, 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.