NPIMap

Organization Active NPI

Lafayette Pediatric Dentistry & Orthodontics

  • Dentist
  • Lafayette, IN
National Provider Identifier
1477869378
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12009779A Issued in IN
Legal business name
LAFAYETTE PEDIATRIC DENTISTRY & ORTHODONTICS
Practice address
2347 Cason St
Lafayette, IN 47904-2670
Phone
(765) 447-6808
NPI assigned
Aug 30, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Authorized official

Name
Dr. Edward M Sammons, DDS MSDNPI 1689752685
Title
Dentist
Phone
(765) 447-6808

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 12009779A IN Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 12006588A IN
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 12011006A IN

Addresses

Primary practice location

2347 Cason St
Lafayette, IN 47904-2670

Mailing address

2347 Cason St
Lafayette, IN 47904-2670
Phone (765) 447-6808

National Provider Directory

National Provider Directory

Locations

2347 Cason St
Lafayette, IN 47904
Phone (765) 447-6808

Practitioners & affiliated clinicians

Practitioners 5

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": "1283126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1477869378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2347 CASON ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042670",
            "telephone_number": "765-447-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2347 CASON ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042670",
            "telephone_number": "765-447-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFAYETTE PEDIATRIC DENTISTRY & ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-30",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "SAMMONS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "765-447-6808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MSD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12009779A",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12006588A",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011006A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.