East Warsaw Dental Group LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

54000313A Issued in IN

Legal business name

EAST WARSAW DENTAL GROUP LLC

Practice address

2104 E Center St
Warsaw, IN 46580-3704

Phone

(574) 269-1787

Fax

(574) 267-1610

NPI assigned

Aug 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John W Jones, DDSNPI 1205949849

Title

DDS

Phone

(574) 269-1787

Specialties & licenses 1

Addresses

Other names 1

• East Center Dental Doing business as

Practitioners 3

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

• John W Jones, DDS

  • General Practice Dentistry
  • Warsaw, IN
  • NPI 1205949849
  NPD (past) Authorized official
• Michael Lawrence Rudolph, D.D.S.

  • Dentist
  • Warsaw, IN
  • NPI 1730305905
  NPD (past)
• Karen L Scripture, DDS

  • General Practice Dentistry
  • Warsaw, IN
  • NPI 1407969983
  NPD (past)

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1366636870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 E CENTER ST",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803704",
            "telephone_number": "574-269-1787",
            "fax_number": "574-267-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 E CENTER ST",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803704",
            "telephone_number": "574-269-1787",
            "fax_number": "574-267-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST WARSAW DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "574-269-1787",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "54000313A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Center Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donald A Durecki, MD
• Jenelle Dushane, PHARM D
• Dennis-James Dutcher, MA
• Mamata Eagam, DO
• East Center Dental
• Rachel Easterling
• Lucy Eberly, LCSW
• Brooke Alise Ebersole, OPT
• Rickard Eby, MA
• Dawn M Eckert, MA, LMHC, LCAC

• General Practice Dentistry in Warsaw, IN
• Providers in Warsaw, 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 Aug 29, 2007; 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.