NPIMap

Organization Active NPI

Heartland Dental Care of Indiana, PC

  • Dentist
  • Kokomo, IN
National Provider Identifier
1497954622
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
HEARTLAND DENTAL CARE OF INDIANA, PC
Doing business as
Kokomo Oral Implantology
Practice address
315 W Lincoln Rd
Suite B
Kokomo, IN 46902-3850
Phone
(765) 453-7692
Fax
(765) 453-7694
NPI assigned
Jul 17, 2007
Organization subpart
Yes
Parent organization
HEARTLAND DENTAL CARE OF INDIANA, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Authorized official

Name
Amy Kroeger
Title
Ins Coor
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

315 W Lincoln Rd
Suite B
Kokomo, IN 46902-3850

Mailing address

315 W Lincoln Rd
Suite B
Kokomo, IN 46902-3850
Phone (765) 453-7692

Other names 1

  • Kokomo Oral Implantology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of Indiana PC48 organizations share this tax ID, including this one
Part of
Heartland Dental Care of Indiana PC

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

View all 47

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1497954622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W LINCOLN RD",
            "address_2": "SUITE B",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023850",
            "telephone_number": "765-453-7692",
            "fax_number": "765-453-7694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W LINCOLN RD",
            "address_2": "SUITE B",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023850",
            "telephone_number": "765-453-7692",
            "fax_number": "765-453-7694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND DENTAL CARE OF INDIANA, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTLAND DENTAL CARE OF INDIANA, PC",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "KROEGER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "INS COOR",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kokomo Oral Implantology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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.