Individual provider Active NPI

Daniel Frederick Lindborg, DDS

  • General Practice Dentistry
  • South Bend, IN
National Provider Identifier
1447428248
Registry record updated Feb 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12007260A Issued in IN
Practice address
52303 Emmons Road
Suite 17
South Bend, IN 46637-4294
Phone
(574) 277-1551
Fax
(574) 277-1552
NPI assigned
Feb 14, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12007260A IN Primary

Addresses

Primary practice location

52303 Emmons Road
Suite 17
South Bend, IN 46637-4294

Mailing address

52303 Emmons Road
Suite 17
South Bend, IN 46637-4294
Phone (574) 277-1551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202947200000",
    "number": "1447428248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52303 EMMONS ROAD",
            "address_2": "SUITE 17",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466374294",
            "telephone_number": "574-277-1551",
            "fax_number": "574-277-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52303 EMMONS ROAD",
            "address_2": "SUITE 17",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466374294",
            "telephone_number": "574-277-1551",
            "fax_number": "574-277-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDBORG",
        "first_name": "DANIEL",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-14",
        "last_updated": "2008-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12007260A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; 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.