NPIMap

Organization Active NPI

Kentland Family Dentistry

  • Dentist
  • Kentland, IN
National Provider Identifier
1366854143
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1639581507 Issued in IN
Legal business name
KENTLAND FAMILY DENTISTRY
Practice address
310 E Lincoln St
Kentland, IN 47951-1135
Phone
(219) 474-5059
NPI assigned
May 28, 2014
Last updated
May 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Authorized official

Name
Dr. Melinda Sue Bodine, DDSNPI 1639581507
Title
Associate
Phone
(219) 474-5059

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1639581507 IN Primary

Addresses

Primary practice location

310 E Lincoln St
Kentland, IN 47951-1135

Mailing address

310 E Lincoln St
Kentland, IN 47951-1135
Phone (219) 474-5059

National Provider Directory

National Provider Directory

Locations

310 E Lincoln St
Kentland, IN 47951
Phone (219) 474-5059

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401235200000",
    "number": "1366854143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E LINCOLN ST",
            "city": "KENTLAND",
            "state": "IN",
            "postal_code": "479511135",
            "telephone_number": "219-474-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E LINCOLN ST",
            "city": "KENTLAND",
            "state": "IN",
            "postal_code": "479511135",
            "telephone_number": "219-474-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTLAND FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-28",
        "last_updated": "2014-05-28",
        "status": "A",
        "authorized_official_last_name": "BODINE",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "ASSOCIATE",
        "authorized_official_telephone_number": "219-474-5059",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "1639581507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentland, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.