Wabash Valley Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WABASH VALLEY DENTAL GROUP

Practice address

1518 S 3Rd St
Terre Haute, IN 47802-1012

Phone

(812) 232-2557

Fax

(812) 234-1365

NPI assigned

May 7, 2007

Last updated

Jun 17, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Suzanne Lindley

Title

Receptionist

Phone

(812) 232-2557

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 2

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.

• Gregory D. Jennings, DDS

  • General Practice Dentistry
  • Terre Haute, IN
  • NPI 1285686121
  NPD (past)
• Lester Lee Tyler, D.D.S

  • Dentist
  • Terre Haute, IN
  • NPI 1447333620
  NPD (past)

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1487866711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 S 3RD ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478021012",
            "telephone_number": "812-232-2557",
            "fax_number": "812-234-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 S 3RD ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478021012",
            "telephone_number": "812-232-2557",
            "fax_number": "812-234-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WABASH VALLEY DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "LINDLEY",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "RECEPTIONIST",
        "authorized_official_telephone_number": "812-232-2557",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200499690A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "524674",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michele Vogel
• Shalyn Idell Vrzina, RBT
• Lazaro Vu
• Wabash Cardiology Associates, LLC
• Wabash Valley Children's Dentistry
• Wabash Valley Dermatology and Med Spa Inc
• Wabash Valley Gastroenterology, LLC
• Wabash Valley Health Center, Inc.
• Wabash Valley Health Center, Inc. (St. Ann Clinic, St. Ann Dental Services, St. Ann Community Outreach Se)
• Wabash Valley Hospitalists LLC (no dba Wabash Valley Hospitalists LLC)

• General Practice Dentistry in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.