Organization Active NPI

Dental Care Action Inc

  • General Practice Dentistry
  • Bloomington, IN
National Provider Identifier
1477765022
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10850A Issued in IN
Legal business name
DENTAL CARE ACTION INC
Doing business as
Dental Care Center
Practice address
1602 W Third Street
Bloomington, IN 47404
Phone
(812) 339-7700
Fax
(812) 339-7794
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. John T Patrick
Title
President Board of Directors
Phone
(812) 339-5015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 10850A IN Primary

Addresses

Primary practice location

1602 W Third Street
Bloomington, IN 47404

Mailing address

1602 W Third Street
Bloomington, IN 47404
Phone (812) 339-7700

Other names 1

  • Dental Care Center Doing business as

National Provider Directory

National Provider Directory

Locations

1602 W 3rd St
Bloomington, IN 47404
Phone (812) 339-7700

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477765022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 W THIRD STREET",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "47404",
            "telephone_number": "812-339-7700",
            "fax_number": "812-339-7794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 W THIRD STREET",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "47404",
            "telephone_number": "812-339-7700",
            "fax_number": "812-339-7794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL CARE ACTION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PATRICK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT BOARD OF DIRECTORS",
        "authorized_official_telephone_number": "812-339-5015",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "10850A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.