The Dental Specialists Indiana PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

THE DENTAL SPECIALISTS INDIANA PC

Practice address

10012 Calumet Ave Ste B
Munster, IN 46321-4055

Phone

(630) 556-2062

NPI assigned

Jun 14, 2022

Organization subpart

No

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

Authorized official

Name

Joanna Prokop

Title

Cfo

Phone

(630) 556-2062

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655164800000",
    "number": "1457081390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17W110 22ND ST STE 150",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601814454",
            "telephone_number": "630-556-2062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 CALUMET AVE STE B",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463214055",
            "telephone_number": "630-556-2062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DENTAL SPECIALISTS INDIANA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "PROKOP",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "630-556-2062"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daria B Terrell, MD
• Terry Ebert, MD, Inc
• Kongkiet Thaera, M.D.
• Jayesh Thakrar, M.D.
• Nicole Karin Thate
• The Dialysis Center of Munster LLC
• The Women'S Wellness Center, P.C.
• Gary John Thomas, DPM
• Nya Simone Thomas
• Kelley Ann Thompson, NNP

• All providers in Munster, IN
• Dental Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.